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UNIVERSITY 

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SCHOOL  OF  LAW 
LIBRARY 


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MEDICAL  SCIENCE 

AND  CRIMINAL 

JUSTICE 


By  HERMAN  M.  ADLER,  M.D. 


PART  V 

OF  THE  CLEVELAND  FOUNDATION  SURVEY  OF 

CRIMINAL  JUSTICE   IN   CLEVELAND 
Price  50  Cents 


MEDIC.AJL  SCIENCE  AND  CRIAONAL  JUSTICE 


THE  CLEVELAND  FOUNDATION 

1202  Swelland  Building,  Cleveland,  Ohio 

COMMITTEE 

J.  D.  Williamson,  Chairman 

Thomas  G.  Fitzsimons 

Malcolm  L.  McBride 

W.  H.  Prescott 

Belle  Sherwin 

Leonard  P.  Ayres,  Secretary 
James  R.  Garfield,  Counsel 


Raymond  Moley,  Director 


THE  SURVEY  OF  CRIMINAL  JUSTICE 
Roscoe  Pound 


Felix  Frankfurter  ^ 

Amos  Burt  Thompson,  Chairman  of  the 
Advisory  Committee 


MEDICAL  SCIENCE 

AND  CRIMINAL 

JUSTICE 


BY 

HERMAN  M.  ADLER,  M.D. 

STATE  CRIMINOLOGIST  OF  ILLINOIS 


PART  V 

OF  THE  CLEVELAND  FOUNDATION  SURVEY  OF 

CRIMINAL   JUSTICE   IN   CLEVELAND 


Copyright,  1921,  by 
The  Cleveland  Foundation 


FOREWORD 

THIS  is  one  of  eight  sections  of  the  report  of  the  Cleveland 
Foundation  Survey  of  Criminal  Justice  in  Cleveland.     The 
survey  was  directed  and  the  reports  edited  by  Roscoe  Pound 
and  Felix  Frankfurter.    Sections  which  have  been  pubUshed  are: 

The  Criminal  Courts,  by  Reginald  Heber  Smith  and  Herbert  B. 

Ehrmann 
Prosecution,  by  Alfred  Bettman 

Other  sections  to  be  pubhshed  are : 

Police,  by  Raymond  Fosdick 

Penal  Treatment  and  Correctional  Institutions,  by  Burdette  G. 

Lewis 
Newspapers  and  Criminal  Justice,  by  M.  K.  Wisehart 
Legal  Education  in  Cleveland,  by  Albert  M.  Kales 
Criminal  Justice  in  the  American  City,  a  Summary,  b}'  Roscoe 

Pound 

The  sections  are  being  published  first  in  separate  form,  each 
bound  in  paper.  About  November  1  the  report  will  be  available 
in  a  single  volume,  cloth  bound.  Orders  for  separate  sections  or 
the  bound  volume  may  be  left  with  book-stores  or  with  the  Cleve- 
land Foundation,  1202  Swetland  Building. 


PREFATORY  NOTE 

THIS  section  of  the  Cleveland  Foundation  Survey  of  Criminal 
Justice  which  deals  with  Medical  Science  and  Criminal  Justice 
was  designed  by  Dean  Pound  primarily  to  answer  the  question, 
"How  far  are  modern  methods  of  psychological  and  psychopathic  in- 
vestigation and  treatment  made  use  of  or  available  in  Cleveland?" 

While  the  original  conception  of  Dean  Pound  has  been  kept  prac- 
ticall}^  intact,  the  scope  of  the  inquiry  has  been  slightly  enlarged  so  as 
to  include  not  only  the  mental  phases  of  medical  relations,  but  all  ques- 
tions of  health  which  had  any  direct  relation  to  the  administration  of 
justice.  This  was  necessitated  partly  by  the  fact  that  one  very  impor- 
tant chapter  in  the  inquiry,  namelj^  the  office  of  coroner,  had  little,  if 
any,  primarj'  connection  with  psychology  or  psychiatry,  but,  above  all, 
by  the  fact  that,  once  the  survey  was  under  way,  it  appeared  that 
medical  relations  must  be  interpreted  in  the  broadest  possible  way  in 
order  to  comply  with  the  program  outlined  by  Dean  Pound. 

In  the  collection  of  data  and  in  making  special  investigations  thanks 
are  due  to  Maurice  R.  Davie,  of  the  Department  of  Sociology  of  Yale 
University,  for  his  valuable  contribution;  to  Miss  Helen  Chew,  of  the 
staff  of  the  Cleveland  Foundation,  for  assistance  both  in  the  collection 
of  information  and  in  the  planning  and  execution  of  the  report ;  to  E.  K. 
Wickman,  Psychologist  in  the  Division  of  the  Criminologist  of  Illinois, 
for  his  work  in  connection  with  the  intelhgence  survey  of  the  Cleveland 
police  force  and  the  Cleveland  House  of  Correction;  to  C.  E.  Gehlke, 
Leonard  V.  Harrison,  and  all  the  members  of  the  Survey  staff  for  much 
help  for  which  specific  acknowledgment  is  impossible. 

The  work  of  this  section  complements  in  some  measure  that  of  the 
section  on  Penal  Treatment  and  Correctional  Institutions,  and  the 
author  has  had  the  cooperation  of  its  director,  Commissioner  Burdette 
G.  Lewis,  of  New  Jersey,  to  whom  he  is  deeply  indebted  for  assistance 
and  advice. 

To  the  Medical  Sub-committee  of  the  Advisory  Committee,  the 
author  wishes  to  express  appreciation  for  kindly  support  and  helpful 
suggestions.  To  Chairman  H.  L.  Sanford  and  Dr.  Howard  Karsner 
the  author  is  especially  indebted  for  information  and  assistance  in  deal- 
ing with  the  subject  of  the  coroner's  office. 

(vii) 


The  author  is  glad  to  acknowledge  here  his  indebtedness  to  two 
previous  surveys  conducted  in  Cleveland,  and  especially  his  personal 
debt  to  Colonel  Leonard  P.  Ayres,  who  directed  the  Cleveland  Founda- 
tion Educational  Survey,  and  Dr.  T.  W.  Salmon,  of  the  National  Com- 
mittee for  Mental  Hygiene,  who  directed  the  Mental  Hygiene  Section 
of  the  Cleveland  Hospital  and  Health  Survey,  for  assistance  and  in- 
formation without  which  this  section  of  the  present  survey  could  not 
have  been  written. 

Herman  M.  Adler,  M.D. 


viii  I 


TABLE  OF  CONTENTS 

PAGE 

Foreword  v 

Prefatory  Note  vii 

List  of  Tables  xi 

List  of  Diagrams  xi 

chapter 

L  Psychiatry  and  Crime  1 

IL  Juvenile  Behavior  Problems  3 

The  Need  for  Mental  Health  Stations  3 

The  Juvenile  Behavior  Problem  in  the  Schools  5 

Recommendations  6 

The  Juvenile  Behavior  Problem  in  the  Courts  7 

Recommendations  8 

IIL  The  Adult  Criminal  9 

Progress  of  Mental  Examination  9 

The  Nature  of  Mental  Examinations  10 

Criminal  Detection  by  the  PoUce  14 

1.  Departmental  Health  Work  14 

2.  Pubhc  Health  Problems  15 

3.  Examination  of  Suspects  and  Prisoners  16 
Recommendations  19 

Crime  Detection  by  the  Coroner's  Office  19 

1.  Relation  to  Police  25 

2.  Relation  to  Courts  26 

3.  Relation  to  Prosecutors  27 

4.  Relation  to  the  Bar  27 

5.  Relation  to  the  Medical  Profession  27 

6.  Administrative  Relations  27 

7.  Equipment  28 

8.  Death  Records  29 

9.  Cost  of  Administration  30 
10.  The  Remedy  30 
Recommendations  35 

Prosecution  36 

Adjudication  36 

1.  Municipal  Court  36 

2.  Common  Pleas  Court  37 

3.  Probate  Court  38 
Recommendations  41 

[ix] 


CHAPTER  PAGE 

IV.  Prevention  42 

Early  Detection  of  Special  Cases  42 

Public  Information  and  Education  44 

Research  45 

Training  of  Workers  and  Experts  46 

Recommendations  47 

Appendix  I. — Report  of  Intelligence  Survey  of  the  Cleveland  Police 

Department  48 

Appendix  II. — Intelligence  Survey  of  the  Cleveland  Workhouse  55 

Appendix  III. — Text  of  the  Massachusetts  Medical  Examiner  Law  58 

Appendix  IV. — Text  of  the  New  York  Medical  Examiner  Law  65 


LIST  OF  TABLES 

TABLE  PAGE 

1.  Distribution  of  Intelligence  Ratings  50 

2.  Summary  of  Distribution  of  Intelligence  Ratings  51 

3.  Median  Scores  and  Range  of  Scores  of  Police  Divisions  52 

4.  Intelligence  Distribution  of  Patrolmen  by  Date  of  Entry  into  the  Department     54 

5.  Distribution  of  Intelligence  Ratings  in  the  Workhouse  56 


LIST  OF  DIAGRAMS 

DIAGRAM  PAGE 

1.  InteUigence  ratings  of  divisions  of  Cleveland  police  department  49 

2.  Median  scores,  Cleveland  police  department  53 

3.  Range  of  scores  between  first  and  third  quartiles  of  Cleveland  police  depart- 

ment.    (The  median  scores  are  indicated  by  the  cross  lines.)  53 

4.  Comparison  of  intelligence  distributions  of  Cleveland  Workhouse  and  United 

States  Draft  Army  56 

5.  Comparison  of  intelligence  ratings,  Warrensville  Workhouse,  with  United 

States  Draft  Army  56 


MEDICAL  SCIENCE  AND  CRIMINAL 
JUSTICE 

CHAPTER  I 
PSYCHIATRY  AND  CRIME 

CLEVELAND,  like  many  other  communities,  is  beginning  to  rec- 
ognize the  medical  and  more  especially  the  psychiatric  aspects  of 
delinquency  and  crime,  though  as  yet  this  recognition  is  confined 
to  a  relatively  small  part  of  the  community,  even  of  the  official  com- 
munity. Some  provision  has  already  been  made  for  psj'chiatric  service, 
but  only  in  more  or  less  isolated  centers  which  are  not  as  yet  correlated, 
and  which,  therefore,  fail  to  give  comprehensive  attention  to  the  entire 
field.  The  immediate  problem,  therefore,  is  to  determine  upon  a  policy 
which  will  utiKze  all  the  existing  elements  and  yet  insure  expansion  and 
development. 

Specialists  in  the  different  fields  of  delinquency,  dependencj^  and 
criminality  are  fully  awake  to  the  problem;  there  is  even  some  general 
public  interest  in  the  subject  as  a  result  of  the  publicity  given  to  it  during 
the  war.  In  Cleveland  this  is  especially  true,  because  the  education  and 
health  surveys  have  dealt  with  the  question,  each  from  its  particular 
angle. 

Nevertheless,  from  the  special  point  of  view  of  the  administration  of 
criminal  justice  much  more  must  be  done  to  remove  the  general  belief 
that  delinquency  and  crime  are  entirely  under  the  volitional  control  of 
the  individual.  The  result  of  this  attitude  has  been  to  make  the  treat- 
ment applied  in  each  case  dependent  in  a  large  measure  on  the  degree  of 
anger  or  annoyance  to  which  the  community  has  been  aroused.  Vindic- 
tive and  punitive  treatment,  even  though  exercised  by  a  group,  loses 
little  of  the  personal  element.  The  community  says  to  the  delinquent: 
"You  could  behave  yourself  if  you  wanted  to.  If  you  break  the  laws,  it 
is  because  you  intended  to,  and  therefore  we  are  going  to  get  even  with 
you."  The  dehnquent  says  to  the  community:  "  You  do  not  need  to  be 
so  rough  with  me,  because  it  is  in  your  power  to  be  more  lenient.  If  you 
2  [1] 


are  rough,  it  is  because  you  want  to  be  unfair  to  me,  and  therefore  I  have 
a  perfect  right  to  hit  back  if  I  can." 

There  was  a  time  when  medicine  was  practised  on  much  the  same 
basis,  and  even  when  chemistry  was  regarded  from  this  point  of  view. 
All  the  ailments  of  the  human  body  were  believed  to  be  the  machinations 
of  evil  spirits.  The  reactions  of  chemical  substances  in  the  retort  were 
thought  to  be  presided  over  by  good  and  evil  spirits.  The  scientific  atti- 
tude which  has  removed  these  personal  elements  in  the  fields  of  pure 
science  and  of  medicine  is  capable  of  doing  the  same  in  criminology.  The 
introduction  of  exact  methods  in  medicine  has  never  interfered  with  the 
highest  effectiveness  of  personality  and  character  in  the  application  of 
the  science  to  the  individual  sufferer.  In  the  same  way  the  introduction 
of  knowledge  into  the  field  of  delinquency  does  not  diminish  the  value  of 
personal  skill  and  of  the  so-called  "human  element"  in  its  application  to 
the  administration  of  justice. 

When  the  public  becomes  convinced  that  there  are  in  the  community 
specially  trained  persons  who  understand  delinquency  and  are  able  to 
evaluate  the  various  factors  in  a  case  of  behavior  difficulty,  the  result  will 
be  like  that  already  witnessed  in  the  field  of  pubhc  health.  Few  persons 
today  have  to  be  coerced  to  be  protected  against  disease  or  to  be  treated 
when  they  are  ill.  Our  dispensaries  and  hospitals  clearly  testify  to  that 
fact.  When  the  public  has  learned  to  regard  behavior  difficulties,  delin- 
quency, and  crime  as  manifestations  of  mental  difficulties  requiring 
treatment,  just  as  physical  ailments  do,  and  provides  institutions  and 
officers  to  deal  with  these  troubles  as  mental  disease,  rather  than  from  the 
point  of  view  of  punitive  justice,  we  shall  be  able  to  record  advances  as 
notable  as  those  of  the  public  health  movement.  And  just  as  public 
health  machinery  has  made  large  cities  and  small  country  villages  healthy 
places  in  which  to  live,  so  this  new  public  mental  health  movement  will 
make  our  communities  safe  and  sane  places  in  which  to  live. 


2] 


CHAPTER  II 
JUVENILE  BEHAVIOR  PROBLEMS 

The  Need  for  Mental  Health  Stations 

THERE  is  probably  no  one  who  has  not  passed  through  difficulties 
during  childhood.  Indeed,  the  great  majority  believe  they  have 
been  saved  from  becoming  delinquent  by  some  fortuitous  circum- 
stance, by  the  strict  discipline  of  their  parents,  by  the  friendly  offices  of 
others,  or  perhaps  that  they  were  not  saved  but  have  in  some  way 
merely  outgrown  delinquency  or  "gotten  by"  in  other  ways.  To  those 
who  look  back  from  a  secure  position  in  society  upon  an  adventurous  and 
unlucky  childhood  or  youth,  it  must  appear  that  every  individual  has 
been,  at  one  time  or  another,  more  or  less  dehnquent.  "There,  but  for 
the  grace  of  God,  goes  John  Bunyan,"  expresses  their  unconscious  feeling 
when  they  consider  criminality.  Whatever  truth  there  may  be  in  this, 
it  does  not  adequately  explain  the  phenomenon  of  delinquency  in  its 
serious  forms  to  one  who  differentiates  between  the  significance  of  a  single 
act  and  a  series  of  reactions  as  disclosed  by  a  study  of  the  career  of  a 
delinquent  individual.  Regarded  with  the  objectivity  of  the  behaviorist, 
acts  which  may  appear  to  be  identical  are  found  to  have  an  entirely  dif- 
ferent significance.  This  is  a  point  of  view  which  the  law — the  emphasis 
of  which  is  on  the  crime  rather  than  on  the  criminal — does  not,  as  3'et, 
sufficiently  recognize,  though  the  law,  to  be  sure,  does  recognize  two 
groups  of  offenders  needing  special  treatment — the  irresponsible  and  the 
juvenile. 

In  dealing  with  adult  criminals,  a  finding  of  feeble-mindedness  or  of 
insanity  seems  to  some  like  condoning  the  crime,  while  to  others  that 
decision  is  merely  the  pronouncement  of  what  they  believe  to  be  a  well- 
estabhshed  truth,  namely,  that  all  criminals  are  ipso  facto  insane  or 
feeble-minded.  However,  all  the  partisanship  and  bitter  feeling  often 
aroused  in  cases  of  serious  adult  criminality  are  either  absent  or  in  abey- 
ance in  the  case  of  juvenile  delinquents.  The  entire  development  of  the 
Juvenile  Courts  rests  on  the  wilhngness  of  the  community  to  believe  that 
the  child  is  not  accountable  for  his  misconduct  in  the  same  sense  as  the 
adult. 

From  the  point  of  view  of  the  behaviorist,  one  cannot  hazard  any 

(31 


generalizations  as  to  the  causation  of  delinquency,  but  must  make  each 
case  the  subject  of  independent  study.  These  considerations,  pushed  a 
little  further,  make  us  reahze  that  similarity  of  behavior  between  youth- 
ful individuals  does  not  imply  identical  causes,  and  therefore  does  not 
demand  identical  treatment.  Perhaps  nothing  will  help  this  point  of 
view  to  gain  general  recognition  so  much  as  the  introduction  of  faciUties 
for  consultation  with  mental  and  behavior  experts,  of  which  the  general 
pubUc  may  avail  itself. 

Parents,  teachers,  even  children  themselves,  may  be  taught  to  consult 
the  mental  health  station  about  their  private  affairs  without  fear  of 
hostile  criticism  or  condemnation,  confident  that  though  the  experts  may 
not  be  able  to  solve  their  problems,  they  will  at  least  give  non-partisan 
counsel.  There  will  be  no  question  whether  the  expert  is  for  or  against 
them  any  more  than  in  the  case  of  the  hospital  physician.  The  question 
will  be  merely  what  is  the  matter  and  what  can  be  done. 

In  this  work  all  the  agencies  of  the  community  should  assist.  The 
public  health  system,  especially  with  its  public  health  nurses  reaching 
into  the  homes,  should  direct  cases  suited  to  the  mental  health  station. 
All  the  welfare  agencies,  through  their  social  service,  should  daily  dis- 
cover cases  requiring  the  assistance  of  a  mental  health  officer.  The 
police  could  easily  be  instructed  in  the  nature  of  the  cases  that  should 
be  directed  to  the  public  health  stations. 

All  of  this  field  work,  however,  depends  upon  the  existence  of  properly 
equipped  mental  health  stations  as  bases.  These  stations,  as  a  rule,  so 
far  as  they  exist  in  Cleveland  and  other  communities,  resemble  dispen- 
saries more  than  hospitals.  This  out-patient  service,  if  properly  con- 
ducted and  enlarged,  will  take  care  of  a  large  percentage  of  the  cases. 
There  are  certain  cases,  however,  which  either  for  diagnosis  or  for  tem- 
porary or  preliminary  treatment,  require  something  more  than  out- 
patient treatment.  For  these,  observation  or  temporary  care  stations 
should  be  provided. 

The  present  plans  in  Cleveland  include  a  psychopathic  hospital  as 
part  of  the  city  hospital,  and  ultimate^  a  psychiatric  institute  in  con- 
nection with  Lakeside  or  Fairview  Hospitals.  The  psychopathic  hos- 
pital will  take  care  of  certain  cases  of  juvenile  dehnquency  in  which  the 
psychotic  and  psychopathic  factors  predominate.  It  is  not  likely,  how- 
ever, that  such  institutions  will  be  ai^le  to  care  for  a  large  number  of 
behavior  cases  which  require  observation,  but  in  which,  nevertheless,  the 
psychotic  factor  is  either  of  minor  importance  or  absent  altogether. 

In  order  to  meet  the  reciuiremcnts  of  the  situation  the  Boys'  School 
and  the  Detention  Home  would  either  have  to  be  converted  into  behavior 

14] 


observation  clinics  with  assistants  and  staff  suitably  trained  in  psychia- 
tr}-;  or,  if  they  are  to  be  retained  as  custodial  or  educational  institutions, 
a  new  type  of  institution  would  have  to  be  provided.  The  Bureau  for 
Juvenile  Research  at  Columbus,  which  is  a  hnk  in  the  institutional  chain, 
might  serve  in  certain  respects  as  a  model  for  a  local  institute.  The  chief 
defect  of  the  bureau,  as  was  emphasized  by  Dr.  Thomas  W.  Salmon  in 
the  health  survey,  is  that  it  deals  with  cases  only  after  they  have  been 
committed. 

What  is  needed,  then,  in  addition  to  the  psychopathic  hospital  at 
Cleveland  and  the  Bureau  for  Juvenile  Research  at  Columbus,  is  a  Chil- 
dren's Institute  at  Cleveland,  either  as  a  branch  of  the  Columbus  bureau 
or  of  the  psychopathic  hospital,  or  an  independent  unit  affiliated  and 
coordinated  with  the  Juvenile  Court,  the  Department  of  Education,  the 
psychopathic  hospital,  and  the  University.  It  is  preferable  to  keep  such 
an  institute  distinct  from  the  psychopathic  hospital  because  the  emphasis 
on  mental  disease  has  a  deterrent  effect  upon  the  pubHc,  and  also  because 
the  work  of  such  an  institute  is  sufficiently  important  to  merit  exclusive 
attention. 

With  some  such  provision  the  city  of  Cleveland  would  be  able  to  deal 
effectively  with  the  general  problem  of  "  criminal  behavior  "  by  attacking 
the  problem  at  its  source — in  childhood.  The  saving  in  human  careers, 
quite  aside  from  the  effect  upon  the  safety  of  hfe  and  property,  would 
more  than  repay  the  community  for  the  relatively  small  expenditure 
involved. 

The  Juvenile  Behavior  Problem  in  the  Schools 
Speaking  solely  from  the  point  of  view  of  the  relation  of  mental 
studies  to  dehnquency,  the  Cleveland  schools  are  now  very  inadequately 
equipped  to  deal  with  behavior  difficulties  and  the  educational  treatment 
of  such  cases.  The  facts  which  compel  this  conclusion  have  already  been 
indicated  by  Dr.  Salmon  in  Part  VI  of  the  health  survey. 

The  Department  of  Education,  as  in  all  our  larger  cities,  has  provided 
special  cla.sses  for  children  with  retarded  or  low  inteUigence.  The  Boys' 
School  might  be  considered  a  special  class  for  behavior  difficulties  in  boys. 
Educational  and  vocational  questions  are  considered  in  practically  all 
cases  of  juvenile  delinquency,  especially  at  the  Boys'  School,  and  the 
physical  condition  also  is  carefully  considered  by  the  school  physicians. 
But  all  this  is  done  in  a  more  or  less  uncorrected  way.  The  physician 
works  from  too  narrow  a  point  of  view.  To  him  a  boy  who  is  a  ward  of 
the  court  bn  account  of  dehnquency,  if  he  has  any  physical  defect  or 
ailment,  is  exactly  the  same  as  any  other  case  suffering  from  the  same 

15] 


physical  troubles.  The  intelligence  rating,  as  well  as  the  educational 
and  vocational  tests,  are  made  in  the  same  way.  What  is  entirely  lacking 
is  the  interpretation  of  the  behavior  difficulties,  and  for  this  the  social 
factors,  which  are  fully  as  important  as  the  physical  or  intellectual 
factors,  must  be  studied.  A  careful  analysis,  not  only  of  the  environ- 
mental conditions  under  which  the  child  is  living,  but  also  of  his 
antecedents,  his  inheritance,  and  his  social  past,  must  be  made.  So  far 
as  this  is  done  at  all  in  Cleveland  it  is  done  by  the  overworked  and  under- 
staffed Probation  Department  of  the  Juvenile  Court  and  by  the  Boys' 
School. 

From  this  point  of  view  it  is  obvious  that  the  community  must  assume 
an  entirely  different  attitude  toward  its  correctional  and  reformatory 
institutions.  When  it  comes  to  treating  juvenile  behavior  problems,  we 
have  an  even  bhnder  faith  in  the  curative  effects  of  punishment  than  have 
the  criminal  courts  themselves.  We  erect  buildings  in  which  we  gather 
the  children  who  have  had  trouble  at  home  or  in  school,  or  in  the  streets 
and  parks  of  our  cities,  and  by  the  application  of  what  is  commonly  re- 
ferred to  as  "strict  discipline,"  we  propose  to  relieve  them  and  ourselves 
of  their  difficulties. 

The  officials  who  preside  over  these  institutions  are  usually  as  ill 
equipped  for  constructive  and  scientific  work  as  the  domestics  and  win- 
dow-washers of  a  hospital  to  carry  out  medical  and  surgical  measures  of 
relief.  It  would  never  occur  to  any  one,  in  these  days  of  modern  medi- 
cine, to  entrust  a  ward  full  of  sick  persons  to  the  professional  care  of  a 
cook,  and  yet  that  is  what  we  do  over  and  over  again  in  our  correctional 
and  reformatory  institutions.  When  we  examine  their  provisions  for 
grappling  with  this  sort  of  work,  is  there  a  single  institution  in  this 
country  which  has  provided  for  its  wards  the  same  grade  of  personnel, 
the  same  training  and  expertness,  that  we  find  in  a  good  general  hospital? 

Recommendations 

1 .  A  Division  of  Mental  Health  should  be  created  in  the  Department 
of  Education. 

2.  This  division  should  be  either  coordinated  with  the  division  dealing 
with  physical  health,  or  be  kept  distinct  from  it  so  that  mental  health 
shall  be  given  independent  importance  and  authority. 

3.  The  Mental  Health  Division  should  include  the  present  psycho- 
logic clinics. 

4.  The  mental  health  work  should  be  closely  coordinated  with  the 
Division  of  Special  Education,  or  even  merged  with  it,  provided  the 
mental  health  work  does  not  thereby  suffer  partial  or  total  eclipse.   " 

16] 


5.  The  mental  health  staff  should  be  under  the  direction  of  a  com- 
petent psj'chiatrist. 

6.  The  director  and  staff  of  the  Mental  Health  Division  should  devote 
full  time  to  the  work. 

7.  A  sufficiently  large  and  comprehensive  staff  should  be  provided  to 
assure  that  the  work  is  performed  in  a  satisfactory  manner. 

8.  The  Division  of  Mental  Health  should  cooperate  with  the  Juvenile 
Court,  the  Detention  Home,  the  Welfare  Federation,  and  the  Depart- 
ment of  Public  Welfare,  and  all  such  public  or  private  agencies  as  deal 
with  problems  of  child  welfare. 

The  Juvenile  Behavior  Problem  in  the  Courts 
The  Juvenile  Court  is  practically  dependent  upon  the  city  health 
department  and  cooperating  private  organizations  for  the  physical  wel- 
fare of  the  children  passing  through  the  court,  and  largely  on  the  Depart- 
ment of  Education  for  mental  tests.  There  are  no  regularly  appointed 
medical  or  mental  examiners  attached  to  the  court. 

In  regard  to  physical  health,  only  children  committed  to  the  Deten- 
tion Home  or  the  Boys'  School  are  examined.  A  physician  and  a  nurse 
serve  on  part  time  in  connection  with  these  two  institutions.  There  is  a 
full-time  dentist.  In  addition,  the  court  often  sends  cases  to  hospitals, 
namely,  the  city  hospital,  Fairview  Hospital,  and  Lakeside  Hospital.  The 
Humane  Society  furnishes  the  services  of  a  physician  for  occasional 
cases.  Judge  George  S.  Addams,  the  Juvenile  Court  judge,  hopes  to  have 
a  nurse  on  duty  at  the  court  who  will  give  a  preliminary  examination  to 
all  children,  whether  committed  or  not,  as  they  pass  through,  and  also  a 
physician  to  examine  all  cases  in  the  court  every  day.  At  present  there 
is  no  money  to  permit  such  an  arrangement. 

The  mental  examinations  connected  with  the  Juvenile  Court  consist 
almost  entirely  of  mental  tests.  These  are  applied  under  the  direction  of 
Dr.  Bertha  L.  Luckey,  the  chief  psychologist  of  the  Board  of  Education. 
Dr.  Luckey  and  her  assistants  examine  especially  children  who  have 
turned  out  to  be  problem  cases  in  the  special  schools.  Boys  sent  to  the 
Boys'  School  by  the  court  are  examined  by  Miss  Claire  E.  Walters.  Miss 
Walters  has  her  office  in  a  temporary  building  at  the  Boys'  School.  She 
also  examines  the  girls  and  dependent  boj's  at  the  Detention  Home 
nearby.  If,  in  the  opinion  of  the  psychologist,  a  case  requires  further 
study,  it  is  referred  to  the  Bureau  of  Juvenile  Research  at  Columbus,  or 
a  psychiatrist  may  be  called  in  to  make  a  special  examination.  There  is 
no  psychiatrist  on  the  staff  of  the  court,  the  school  board,  or  the  Depart- 
ment of  Health,  so  that,  naturally,  these  special  examinations  are  made 

17] 


but  rarely.  As  a  result,  the  reports  of  examinations  which  come  back  to 
the  judge  are  confined  merely  to  a  statement  of  the  findings  and  only  in 
the  more  serious  cases  of  foeble-mindedness  is  a  recommendation  for 
commitment  to  the  State  institution  risked  by  the  examiner. 

The  Juvenile  Court  is  officially  without  equipment  for  making  medi- 
cal and  special  mental  examinations.  Whatever  is  done  is  at  the  personal 
request  of  the  judge.  The  results  of  the  various  examinations  are  re- 
ported to  him,  and  frequently  Miss  Walters  appears  as  a  witness.  Neither 
Miss  Walters,  Dr.  Luckej^,  nor  their  assistants  receive  any  extra  com- 
pensation for  this  work.  Other  psychiatrists  and  medical  examiners,  if 
they  appear  as  witnesses,  receive  ordinary  witness  fees. 

In  spite  of  all  these  handicaps  the  work  is  extremely  well  done,  al- 
though necessarily  limited  by  inadequacy  of  equipment.  Judge  Addams 
recognizes  the  value  of  the  work,  however,  and  is  not  only  inclined  to 
follow  recommendations  made,  but  strongly  recommends  an  extension  of 
this  work.  The  relation  between  the  judge  and  the  special  examiners  is 
one  of  close  cooperation  on  both  sides.  The  relation  of  these  examiners 
to  the  probation  officers  is  less  close,  although  through  the  influence  of  the 
judge  and  the  chief  probation  officer  the  facts  disclosed  by  examination 
are  utilized  by  the  latter  in  selected  cases.  Much,  however,  could  be  done 
to  improve  this  part  of  the  work.  The  same  may  be  said  of  the  relation 
between  the  special  examiners  and  the  officers  of  the  Detention  Home. 

Recommendations 

1 .  A  mental  and  physical  examination  should  be  made  of  every  child 
brought  to  the  attention  of  the  Juvenile  Court,  and  careful  records  should 
be  kept  of  the  results  of  each  examination. 

2.  The  examinations  should  be  made  whenever  it  appears  advisable 
to  the  examiners. 

3.  The  present  excellent  cooperation  between  the  Juvenile  Court  and 
the  Department  of  Education  should  be  extended  so  as  to  make  available 
for  both  such  facilities  as  each  may  be  able  to  provide.  This  applies  espe- 
cially to  the  suggested  creation  of  a  Division  of  Mental  Health  in  the 
Department  of  Education.  Such  a  division  might  profitably,  and  with 
little  increase  of  staff,  contribute  to  the  Juvenile  Court  much  needed 
information  in  regard  to  the  intelligence,  mental  qualities,  and  personal- 
ity of  each  chikl  under  consideration  by  the  court. 


(8 


CHAPTER  III 
THE  ADULT  CRIMINAL 

Progress  of  Mental  Examination 

A  DISCUSSION  of  the  medical  relations  bearing  upon  the  adult 
criminal  is  a  matter  of  few  words,  so  far  as  the  present  practice  in 
^  Cleveland  is  concerned.  Except  for  the  occasional  perfectly 
obvious  case,  practically  no  use  is  made  of  medical  and  more  especially 
mental  treatment  in  dealing  with  adult  offenders.  The  majority  of 
citizens  and  officials  no  doubt  believe,  as  a  high  prison  official  in  another 
State  said — "Of  course,  the  out-and-out  feeble-minded  or  insane  prison- 
ers need  special  attention,  but  surely  the  doctors  have  no  interest  in  the 
normal  prisoner."  Does  it  not  depend  upon  the  attitude  with  which  one 
approaches  the  question  of  treatment  whether  mental  experts  are  to 
concern  themselves  solely  with  the  end  stages  of  mental  disease  or  de- 
ficiency, or  with  the  interpretation  and  treatment  of  all  cases  of  behavior 
difficulties,  assuming  them  to  be  in  the  main  problems  of  mentality? 
The  use  of  the  word  normal  should  be  prohibited  as  misleading  in  the 
field  of  behavior  difficulties. 

Experience  in  some  of  our  reformatories  and  penitentiaries  has  con- 
clusively shown  that  the  study  of  mentahty  yields  information  which  no 
modern  institution  can  neglect.  One  need  merely  refer  to  the  well-known 
work  at  Sing  Sing,  Concord,  Elmira,  and  Bedford  Hills,  not  to  mention 
the  institutions  of  New  Jersey,  Michigan,  and  Illinois,  and  especially  the 
United  States  Disciplinary  Barracks  at  Fort  Leavenworth,  Kansas.  The 
elaborate  plans  for  a  psychiatric  clinic  in  the  new  prison  at  Sing  Sing 
clearly  indicate  what  the  New  York  State  officials  think  of  this  work  as 
an  adjunct  of  the  penal  system.  And  what  has  come  more  and  more  to  be 
considered  indispensable  in  an  institution  has  proved  itself  of  similar 
value  to  the  courts.  Mental  examinations  and  personality  studies  are 
now  insisted  upon  as  a  sine  qua  non  in  the  work  of  practically  all  the 
Juvenile  Courts  of  the  country. 

There  is  every  indication  that  this  work  has  so  far  established  itself 
that  criminal  and  police  courts  are  also  availing  themselves  of  the  ad- 
vantages.   Thus,  the  Municipal  Courts  of  Chicago,  Boston,  Detroit,  and 

19] 


Baltimore  have  psychopathic  clinics  or  laboratories  to  which  are  referred 
all  doubtful  cases.  No  city  has  as  yet  worked  out  a  system  by  which  all 
cases  coining  before  the  court  are  considered  from  the  mental  angle. 
When,  as  often  in  court  work,  selection  is  made  by  untrained  persons,  im- 
portant cases  are  frequently  overlooked.  Routine  sorting  examination 
of  all  cases,  with  more  intensive  study  of  those  shown  by  first  examina- 
tion to  require  further  investigation,  is  the  only  safe  way. 

As  long  as  the  public  regards  this  work  as  a  mere  frill  or  an  expression 
of  maudlin  sympathy  for  the  criminal,  of  course,  it  will  not  be  encour- 
aged. What  the  uninitiated  do  not  reahze  is  that  work  of  this  kind  is  a 
very  matter-of-fact  and  practical  step  toward  the  better  administration 
of  the  law,  as  well  as  real  economy. 

The  Nature  of  Mental  Examinations 
Although  in  general  the  pubUc  has  become  familiar  with  the  fact  that 
mental  examinations  are  made  in  many  cases  where  there  is  no  reason  to 
suppose  that  insanity  exists,  there  is  a  great  deal  of  doubt  in  the  minds  of 
many  as  to  the  nature  of  the  methods  and  the  information  they  may  be 
expected  to  yield.  It  may  not,  therefore,  be  amiss  to  give  briefly  the  out- 
lines of  this  work. 

Mental  examinations,  as  they  are  now  made,  may  be  divided  into  two 
main  groups:  The  first,  or  psychometric  method,  sometimes  called  the 
psychological  tests,  consists  in  the  application  of  certain  standardized 
sets  of  tests  with  the  object  of  determining  the  native  mental  abiUty,  or, 
as  it  is  called,  the  "intelligence"  of  the  subject.  Various  forms  of  tests 
are  now  used,  but  practically  all  of  them  are  based  upon  the  work  of  the 
French  scientist,  Alfred  Binet,  who,  together  with  his  collaborator,  Theo- 
dore Simon,  published  in  the  years  1905  to  1908  the  first  scale  for  the 
measurement  of  intelligence  in  children. 

This  scale  is  arranged  in  accordance  with  the  idea  that  as  a  child 
grows  older  and  his  mentality  develops  he  is  able  to  perform  more  and 
more  complicated  acts  and  to  carry  out  more  and  more  complex  intel- 
lectual processes;  so  that,  if  we  arrange  a  series  of  tests,  questions,  and 
problems  in  the  order  of  their  difficulty  and  present  them  to  a  child,  we 
may  be  able  to  infer  his  degree  of  development  by  the  point  in  such  a 
series  beyond  which  he  is  unable  to  answer  questions  satisfactorily.  The 
scale  thus  arranged  by  Binet  has  since  been  tried  out  on  a  large  number 
of  school  children,  and  as  a  result  of  this  experiment  it  has  been  possible 
to  arrange  the  tests  in  groups  of  six  for  each  year.  Since  publication, 
these  tests  have  been  used  to  such  an  extent  as  to  indicate  thoroughly  the 
existing  need  of  such  measurement. 

[10] 


It  soon  developed  that  there  were  in  the  schools  and  elsewhere  in- 
dividuals who,  on  being  subjected  to  these  tests,  failed  more  or  less  widely 
to  come  up  to  the  grade  corresponding  to  their  actual  age,  and  since  the 
tests  had  originally  been  arranged  for  age  groups,  it  was  said  that  their 
chronological  age  or  actual  age  was,  let  us  say,  twelve  years,  and  the 
mental  age  as  determined  by  the  scale  was,  let  us  say,  nine  years. 

As  the  tests  have  become  more  definitely  standardized,  and  as  new 
tests  have  been  devised  and  come  into  use,  the  exact  definiteness  with 
which  the  mental  ages  were  stated  ten  years  ago  has  gradually  become 
subject  to  modification.  Thus,  while  in  the  case  of  school  children  of 
twelve  or  less  it  is  reasonably  satisfactory  to  express  their  deviation  or 
subnormality  in  terms  of  years,  it  is  not  so  clear  when  the  method  is 
applied  to  older  persons.  When  applied  to  adolescents,  and  especially  to 
adults,  these  methods  have  frequently  given  rise  to  increduhty  on  the 
part  of  many ;  an  instance  of  such  a  case  is  when  an  individual  of  twenty- 
five  years  who  is  guilty  of  a  felony,  and  perhaps  has  a  wife  and  children, 
and  in  other  respects  appears  to  be  mature,  is  said  to  have  the  mind  of  a 
child  of  nine  years  as  determined  by  the  mental  tests. 

The  reason  for  this  apparent  discrepancy  is  the  fact  that  the  original 
Binet  scale  and  its  modifications  and  ampHfications  hold  with  consider- 
able accuracy  for  children  of  twelve  and  less,  because  the  innate  intel- 
ligence reaches  its  full  development  at  about  the  age  of  puberty.  This 
statement  is  not  true  in  an  absolute  sense,  but  for  present  purposes  is 
sufficiently  accurate.  The  development  which  goes  on  after  the  age  of 
puberty,  during  the  age  of  adolescence,  and  until  full  adolescent  ma- 
turity is  reached,  is  a  growth  in  strength,  power,  and  the  use  of  the  innate 
ability  through  acquired  habits  and  experience. 

As  this  is  the  period  during  which  the  greatest  apparent  progress  is 
made,  when  the  change  from  childhood  to  adult  maturity  is  visibly  going 
on,  it  is  difficult  at  first  glance  to  reconcile  this  fact  with  the  previous 
statement  in  regard  to  the  maturing  of  intelligence.  A  child  of  twelve  or 
fourteen  may  have  as  much  intelhgence  as  an  individual  of  twenty-five  or 
thirty  years,  and  yet  the  adult  will  far  exceed  the  child  in  intellectual  per- 
formance and  ability.  This  is  because  the  older  person  is  able  to  use  his 
intelligence  much  more  effectively  because  his  emotional  control,  equi- 
librium, and  judgment  are  much  greater  than  those  of  a  child.  Less  diffi- 
culty would  undoubtedly  be  experienced  in  this  regard  had  we  a  measure 
of  the  development  which  takes  place  during  the  adolescent  period  corre- 
sponding to  the  one  we  now  have  for  the  mental  development  during 
childhood. 

The  psychometric  tests,  therefore,  give  us  a  fairly  accurate  statement 

[111 


of  the  degree  of  intelligence  of  any  individual.  All  inferences  regarding 
the  maturity  of  the  individual  in  other  respects,  namely,  emotional  con- 
trol, forbearance,  responsibility,  honesty,  self-denial,  respect  for  others, 
and  the  other  attributes  of  personality  which  determine  an  individual's 
place  in  the  social  scale,  can  be  determined  only  roughly.  We  can  com- 
pare one  individual  with  another  in  regard  to  his  intelligence  rating  and 
can  say  with  considerable  precision  by  how  much  one  excels  another. 
For  the  period  of  adolescent  development,  no  such  exact  measurement  is 
possible,  and  we  have  to  be  content  with  a  "more  or  less,"  "better  or 
worse,"  standardization. 

So  striking  have  been  the  results  achieved  by  means  of  the  Binet- 
Simon  tests  that  in  the  ten  years  since  the  first  publication  this  type  of 
measurement  has  become  firmly  established  in  schools,  courts,  and  insti- 
tutions, in  fact,  wherever  child  welfare  is  concerned. 

Other  scales  have  been  devised  which  furnish  the  information  in  a 
somewhat  different  way,  perhaps  with  greater  precision  than  the  original 
Binet  scale.  Aside  from  the  first  important  modification  of  the  scale,  the 
so-called  Stanford  Revision,  by  Professor  Terman,  of  the  Leland  Stanford 
University,  there  has  been  developed  a  point  scale  by  Professor  Yerkes, 
and  a  number  of  special  tests,  such  as  those  of  Dr.  William  Healy,  Dr. 
Guy  Fernald,  Professor  Whipple,  and  many  others. 

The  problem  of  giving  an  intelligence  rating  to  the  soldiers  of  the 
draft  army  during  the  late  war  gave  an  impetus  to  another  form  of  test 
which  has  been  claiming  attention  in  the  schools,  namely,  that  of  the 
so-called  "group  tests."  This  method,  based  in  general  upon  the  same 
logic  as  the  Binet  tests,  was  so  arranged  that  any  one  who  can  read  and 
write  may  perform  the  test.  The  method  consists  in  an  instructor  read- 
ing certain  instructions  to  the  group,  who  are  equipped  with  pencils  and 
test  blanks,  and  who  then  carry  out  the  instructions,  answering  questions 
and  solving  problems  in  accordance  with  printed  statements,  while  the 
instructor  keeps  time.  In  this  way  as  many  as  1,000  men  can  be  examined 
simultaneously. 

The  scores  made  on  these  tests,  which  are  now  usually  referred  to  as 
the  army  tests,  are  expressed  in  figures:  the  highest  possible  score,  for 
instance,  was  212.  The  performance  varied  throughout  the  entire  range 
from  0  to  212.  In  order  to  express  the  result  in  a  usable  form  the  score 
is  divided  into  five  groups,  designated  by  the  letters  A  to  E  as  follows: 
A,  very  superior;  B,  superior;  C,  average;  D,  inferior;  E,  very  inferior. 
It  was  found  that  so  many  men  fell  into  the  C  or  average  group  that  it 
became  necessary  to  divide  this  into  two  more  groups,  C  plus  and  C 
minus,  high  average  and  low  average  respectively.    The  score  necessary 

(  12] 


for  a  commission  was  judged,  as  a  rule,  to  be  either  A  or  B.  The  men  of 
E  intelligence  included  the  feeble-minded,  the  defective,  and,  in  the 
main,  men  not  fitted  for  the  army  because  of  low  mentality. 

In  evaluating  the  mental  status  of  an  individual  who,  for  one  reason 
or  another,  is  a  subject  for  examination,  more  than  intelligence  rating  is 
required.  This  further  information  is  obtained  by  means  of  certain  men- 
tal examinations  which  have  as  their  object  the  determination  not  so 
much  of  the  qualitative  mental  abiUty  as  of  the  existence  of  diseased  or 
abnormal  functionings  or  reactions.  We  might  visualize  this  by  saying 
that  in  the  intelUgence  field  we  are  taking  a  measure,  just  as  we  might 
measure  the  height  of  an  individual,  and  that  the  differences  are  dif- 
ferences in  mental  stature.  In  the  second  form  of  examination,  namely, 
the  psychiatric  examination,  we  are  looking  not  for  differences  in  height, 
but  for  pathological  processes  comparable  to  disease  processes  in  the  field 
of  physical  health.  This  type  of  examination  seeks  to  determine  the 
existence  or  absence  of  certain  symptoms  of  disease,  and  when  found,  to 
evaluate  their  significance  and  the  severity  of  the  condition.  It  yields 
information  upon  which  may  be  based  such  diagnosis  as  mental  disease  or 
the  less  severe  pathological  conditions,  sometimes  called  psychopathic 
personaUty. 

The  stud}^  of  the  mentality  of  an  individual  from  the  point  of  view  of 
psychiatry  requires  something  further,  however,  than  merely  testing  the 
mind  or  the  nervous  system.  One  cannot  dissect  the  living  human  being 
and  deal  with  one  portion  only.  One  of  the  characteristics  of  a  living 
organism  is  that  every  part  is  in  relation  with  every  other.  Nowhere  is 
this  more  important  than  in  the  pathology  of  the  mind.  Of  late  a  great 
deal  of  attention  has  been  paid  to  the  influence  on  mentality  of  certain 
factors  which  lie  outside  the  nervous  system.  The  existence  of  physical 
disease  elsewhere  in  the  body,  as,  for  instance,  in  the  delirium  of  fever, 
various  intoxications  and  auto-intoxications,  the  effect  of  digestive  dis- 
turbances, and,  above  all,  the  more  newly  disclosed  effects  of  various 
glands  and  organs,  such  as  the  thyroid  and  the  sex  glands,  are  examples 
of  these  factors.  It  will  be  clear,  therefore,  that  the  examination  of 
mentality  from  this  point  of  view  cannot  be  conducted  with  the  same 
apparent  exactness  as  is  often  possible  in  the  investigation  of  the  mental 
age.  It  must  also  be  clear  that  this  type  of  investigation  requires  the 
apphcation  of  all  the  medical  knowledge  available  and  must,  therefore, 
be  made  by  a  medical  man  with  special  experience  in  this  field. 

There  is  another  point  which  must  be  understood  in  order  to  appre- 
ciate why  inedical,  especially  psychiatric,  knowledge  must  be  apphed  in 
addition  to  the  intelligence  rating.    As  we  have  seen  before,  the  intelli- 

1131 


gence  test  is  a  matter  of  measuring  mental  stature.  While  these  methods 
must  be  applied  with  the  greatest  care  in  order  to  be  of  any  value  and, 
therefore,  require  the  services  of  a  highly  trained  specialist,  they  never- 
theless do  not  require  any  medical  or  pathological  knowledge.  In  the  elu- 
cidation of  behavior  difficulties  we  are  confronted  with  a  problem  which 
is  comparable  less  to  an  educational  problem  than  to  a  problem  of 
health.  Even  though  our  object  is  not  to  pin  a  label  on  the  individual 
and  find  him  either  insane  or  feeble-minded,  nevertheless  we  must  arrive 
at  a  diagnosis  of  health  by  exclusion,  for  in  no  other  way  can  a  diagnosis 
be  made.  We  cannot  make  a  diagnosis  of  health  or  of  sanity.  We  can 
only  make  a  diagnosis  of  "no  evidence  of  disease  found."  We  can  posi- 
tively identify  only  the  signs  and  symptoms  of  disease.  In  the  absence  of 
such  we  are  justified  in  assuming  that  a  person  is  healthy.  It  must  be 
clear,  therefore,  that  in  making  this  sort  of  judgment  upon  the  men- 
tality of  individuals  and  in  elucidating  the  mental  factors  in  behavior 
reactions  a  true  knowledge  of  mental  pathology  is  necessary  in  order  to 
allow  this  judgment  by  exclusion. 

The  fact  that  psychiatrists  are  interesting  themselves  more  and  more 
in  the  behavior  problems  of  the  non-insane  should  not  be  interpreted  as 
an  indication  that  the  psychiatrist  is  endeavoring  to  adjudge  everybody 
insane.  But,  on  the  other  hand,  the  commonly  held  fallacy  that  the 
psychiatrist  has  no  interest  in  the  problems  of  the  non-insane  or  mentally 
healthy  individual  should  be  also  dispelled. 

Criminal  Detection  By  the  Police 
1.  Departmental  Health  Work 

The  only  medical  officer  officially  connected  with  the  Division  of 
Police  is  the  police  surgeon.  Only  one  police  surgeon  is  employed.  The 
present  surgeon,  Dr.  G.  P.  O'Malley,  has  held  this  oflftce  since  December, 
1920.  The  duties  of  the  police  surgeon  are,  first,  physical  examination  of 
all  applicants  for  appointment  to  the  police  force,  and,  second,  care  of 
sick  and  disabled  members  of  the  force.  It  will  be  seen  from  this  that  he 
is  concerned  only  with  the  health  of  members  of  the  force  itself  and  not 
at  all  with  medical  or  health  problems  connected  with  the  work  of  the 
police. 

Even  in  this  restricted  application  the  work  of  the  police  surgeon  is 
not  adeciuately  provided  for.  There  are  too  many  men  to  be  examined 
and  the  e(juii)ment  provided  is  in  many  respects  inadequate.  During 
March,  1921,  there  were  800  men  to  be  examined.  Blood  tests  are  not 
being  made,  although  the  police  surgeon  believes  that  such  tests  should 
be  made  in  every  case.    Neither  the  physical  examinations  of  applicants 

[14] 


to  the  force  nor  the  examination  of  men  representing  themselves  as  sick 
can  now  be  made  in  any  but  a  superficial  way. 

The  police  surgeon  has  no  office — merely  a  desk  in  the  office  at  the 
central  station.  There  is  no  room  where  men  can  undress,  and  as  a  result 
the  examinations  cannot  satisfactorily  be  made.  A  change  is  contem- 
plated in  this  respect,  and  new  quarters  are  to  be  provided  at  the  Eighth 
Precinct. 

The  present  officer,  Dr.  O'Malley,  offers  the  following  criticisms  and 
recommendations : 

1.  Better  working  facilities  with  complete  equipment  for  making 
thorough  examination  and  also  for  emergency  treatment. 

2.  Medical  and  clerical  assistance.  The  city  should  be  redistricted  and 
a  police  surgeon  hired  for  each  district.  There  should  be  two  assistants 
hired  immediately  to  enable  the  city  to  be  divided  into  three  districts. 

3.  A  card  index  and  records  of  all  cases  entered  should  be  kept,  and  for 
this  office  space  and  help  are  required.  There  should  be  a  system  of 
records  to  show  exactly  the  number  of  times  each  man  reported  sick  and 
how  much  time  he  loses. 

4.  To  obviate  the  possibility  of  maUngering  there  should  be  a  constant 
checking  up  of  the  records.  These  should  also  show  whether  or  not  a  man 
is  in  such  poor  health  that  he  is  unable  to  perform  active  duty. 

5.  If  an  officer  is  sick  too  often,  he  should  be  called  before  a  medical 
board  and  given  a  thorough  examination,  at  which  time  his  family  physi- 
cian should  be  present,  if  desired. 

6.  All  cases  of  pension  should  be  handled  by  such  a  board. 

7.  The  poUce  surgeon  as  well  as  the  police  officers  should  be  entitled 
to  pension.    This  is  not  the  case  at  present. 

Malingering  in  the  police  department  seems  to  be  somewhat  of  a 
problem  from  the  point  of  view  of  health  work.  The  men  live  scattered 
throughout  the  town  and  at  times  it  is  impossible  for  the  surgeon  to  call 
upon  all  of  them  on  the  same  day  they  report  sick.  Sometimes  it  is  two 
days  or  more  before  the  surgeon  can  see  a  case.  The  men  are  aware  of 
this,  and  the  surgeon  believes  they  take  advantage  of  the  fact  to  take  a 
day  off.  Dr.  O'Malley  believes  that  as  much  as  12  per  cent,  of  the  sick- 
ness might  be  designated  as  malingering,  although  he  has  no  means  of 
saying  definitely,  because  no  records  other  than  the  daily  sick  report 

have  been  kept. 

2.  Public  Health  Problems 

For  all  health  work  outside  the  department  itself,  including  general 
cases  coming  to  the  attention  of  the  police  and  the  examination  of 
suspects  and  prisoners,  the  police  depend  upon  the  Division  of  Health. 

[  15] 


The  city  is  districted,  and  the  Division  of  Health  maintains  district 
physicians.  The  police  may  call  upon  these  in  cases  requiring  medical 
attention.  The  district  physicians  are  supposed  to  confine  themselves  to 
the  care  of  the  indigent  sick  in  their  homes  and  to  protect  the  com- 
munity from  contagious  disease.  In  actual  practice  the  police  call  upon 
the  district  health  offices  in  many  cases  other  than  those  specifically 
mentioned. 

The  police,  furthermore,  are  instructed  to  remove  any  arrested  person 
who  requires  medical  treatment  to  the  nearest  hospital,  preferably  the 
city  hospital,  and  a  police  guard  is  furnished  in  case  such  a  person  is  kept 
at  the  hospital.  There  is  a  special  ward  at  the  city  hospital  for  such 
persons,  in  which  windows  are  barred,  doors  locked,  and  a  guard  con- 
stantly in  attendance. 

The  police,  however,  render  assistance  to  the  general  public  in  health 
matters.  Owing  to  the  fact  that  the  police  are  always  available  for  call, 
people  refer  cases  to  them,  especially  emergency  cases,  which  should 
properly  be  taken  care  of  by  private  physicians.  The  police  keep  on  file 
the  names  and  addresses  not  only  of  the  district  physicians,  but  also  of 
certain  private  physicians  who  have  certified  their  willingness  to  take 
emergency  cases.  Vice  cases  are  referred  to  the  Public  Venereal  Dis- 
ease Clinics  and  to  the  Woman's  Protective  Association.  The  Division 
of  Health  maintains  a  diagnostic  clinic  for  venereal  diseases  at  No.  64 
Public  Square  and  the  Fairview  CUnic  for  Social  Diseases  at  3305  Frank- 
lin Avenue,  mainly  for  treatment.  The  diagnostic  clinic,  under  the 
federal  government  during  the  war,  was  taken  over  by  the  city  in 
September,  1919.  The  Fairview  Clinic  was  started  August  16,  1920. 
These  clinics  handle  private  as  well  as  court  cases.  Under  the  general 
code  all  vice  cases  are  to  be  referred  for  diagnosis  at  the  discretion  of 
the  judge.  There  seems  to  be  considerable  laxity,  however,  in  referring 
cases.  Rape  cases  are  occasionally  handled  at  these  clinics,  although,  as 
a  rule,  such  cases  are  referred  to  the  city  hospital. 

It  appears,  therefore,  that  the  problems  of  health,  either  of  the  police 
force  or  of  the  general  public,  in  so  far  as  the  latter  comes  in  contact  with 
the  police  and  the  courts,  are  provided  for  adequately — if  not  in  practice, 
at  least  in  theory.  The  further  improvement  of  this  service  and  the 
raising  of  the  general  level  of  its  efficiency  is  a  question  of  applying  pres- 
ent knowledge  and  furthering  development  along  well-established  fines. 

S.  Examination  of  Suspects  and  Prisoners 
There  are  certain  other  problems  of  medical  relations,  however,  of 
growing  importance  in  connection  with  crime  detection  which  concern 

I  161 


the  police  and  the  crime-detecting  agencies  more  than  is  commonly  sup- 
posed. 

The  police  have  contacts  with  criminal  and  semi-criminal  elements, 
which  in  many  cases,  if  properly  utilized,  might  result  not  only  in  better 
understanding  of  the  general  subject  of  crime,  but  actually  in  a  more 
effective  deahng  with  it.  A  patrolman  on  the  beat  can  no  longer  ade- 
quately perform  his  full  duty  in  a  city  such  as  Cleveland  by  merely 
representing  in  theory,  and  not  in  practice,  the  majesty  of  the  law.  To 
be  the  eyes  of  the  law  and  of  the  community  his  powers  of  oljservation 
must  be  trained,  so  that  he  may  be  able  to  distinguish  the  significant 
from  the  adventitious. 

This  is  not  the  place  to  discuss  the  details  of  police  administration 
and  police  personnel.  But  it  is  relevant  to  consider  here  the  equipment 
and  skill  necessary  for  individual  police  officers  to  secure  the  information 
needed  to  determine  many  important  problems  of  the  mentality  and 
reliability  of  witnesses,  and  the  relative  honesty  or  dishonesty  of  wit- 
nesses, suspects,  and  prisoners.  One  cannot  depend  upon  chance  in  this 
matter  nor  the  haphazard  school  of  experience.  A  very  precise  prepara- 
tion must  be  made  by  the  authorities  to  provide  the  necessary  training. 
There  seems  to  be  no  escape  from  the  conclusion  that  the  Division  of 
Police  should  in  some  way  be  provided  with  the  services  of  a  speciahst 
in  mental  science,  particularly  in  its  application  to  the  problems  of 
criminal  behavior. 

The  work  of  the  police  surgeon  in  his  professional  supervision  of  the 
health  of  the  poUce  force;  of  the  district  health  officers,  in  their  relation 
to  the  physical  health  of  the  community  in  general,  and  of  prisoners, 
suspects,  and  accidental  cases  in  particular,  should  be  strengthened  by 
the  introduction  of  three  health  officers — two  to  act  as  assistants  to  the 
present  police  surgeon  in  his  routine  work,  and  the  third  a  specialist  who 
should  devote  his  time  and  energies  to  the  mental  aspects  of  the  police 
department  both  within  and  without  the  force.  Such  a  specialist  would 
serve  not  only  as  an  advisor  in  the  department,  but  also  as  a  teacher. 
Mental  health  work  should  really  be  a  subdivision  of  the  health  depart- 
ment, and  it  is  not  unlikely  that  before  long  the  health  department  of 
every  large  city  will  develop  a  special  division  for  mental  health. 

The  problems  which  present  themselves  for  solution  by  mental  science 
in  connection  with  police  work  are: 

First,  the  general  problem  of  the  existence  of  mental  disease  or  mental 
defectiveness  in  persons  under  observation. 

Second,  the  very  important  and  broad  problem  of  pathological  per- 
sonalities. In  a  great  number  of  cases  this  seems  to  be  one  of  the  impor- 
3  [171 


tant  underlying  factors  in  the  interpretation  of  behavior  disorders.  A 
greater  interest  in  these  problems  and  a  more  intelligent  application  of 
the  knowledge  obtained  in  their  scientific  solution  are  essential  if  we  are 
ever  to  reduce  the  seriousness  of  a  large  group  of  problem  cases.  In  order 
to  make  clear  the  meaning  of  this  one  needs  merely  to  refer  to  the  rela- 
tionship between  the  psychopathic  personality  and  vagrancy,  non-sup- 
port, desertion,  inebriety,  drug  addiction,  and  the  types  of  delinquency 
in  which  sex  difficulties  are  a  decisive  factor. 

There  are  certain  special  relations  in  addition  to  these  general  ones 
in  which  mental  science  may  be  of  assistance  to  the  police.  Two  espe- 
cially demand  attention: 

First,  the  general  question  of  malingering,  which  is  to  some  extent  a 
factor  within  the  police  force  and  is  of  the  utmost  importance  in  relation 
to  the  analysis  of  individual  dehnquents  and  criminals.  The  value  of  a 
testimony,  the  reliability  of  a  witness,  the  question  whether  an  individual 
is  shamming  insanity,  injury,  or  disability,  may  often  be  solved  or  at 
least  determined  by  applying  the  rules  of  mental  examination  to  the  in- 
dividuals under  observation. 

The  second  has  to  do  with  forced  confessions  or  the  so-called  "third 
degree."  A  suspect  is  apprehended  and  many  points  of  circumstantial 
evidence  point  to  his  being  the  criminal  or  at  least  implicated  in  a 
criminal  affair.  But  the  chain  of  evidence  is  by  no  means  complete,  and 
the  suspect  denies  more  or  less  successfully  his  guilt  or  complicity.  Under 
such  circumstances  a  confession,  if  gained,  may  be  corroborated  by  evi- 
dence now  easy  to  secure.  Such  a  confession  almost  invariably  simpHfies 
the  work  of  the  police  to  such  a  degree  that  in  many  cases  they  are  bent 
on  securing  a  confession  rather  than  objectively  securing  the  available 
evidence. 

It  is  not  our  wish  here  to  discuss  this  method  from  the  legal  nor  the 
police  aspect.  From  the  point  of  view  of  the  scientist  it  is  a  clearly  in- 
effectual and  dangerous  method.  Not  only  is  it  apt  to  be  misleading,  but 
its  chief  fault  is  that  it  tends  to  accustom  police  officers  to  seek  the  easiest 
way  out  of  a  difficult  situation,  rather  than  to  apply  the  best  methods  of 
scientific  investigation. 

However,  confessions  probably  will  continue  to  be  sought,  and  in 
connection  \^ith  this  work  a  specialist  in  mental  examination  would  prove 
of  a.ssistance.  A  careful  mental  examination  will  disclose  whether  a  per- 
son is  able  to  give  reliable  information,  whether  he  is  suggestible  and  to 
what  degree,  and  therefore  whether  he  will  accept  readily  the  suggestions 
of  the  "third  degree."  Furthermore,  laboratory  methods  are  of  con- 
siderable aid  in  determining  whether  a  person  is  withholding  informa- 

(  IS] 


tion,  whether  he  shows  well-marked  emotional  reactions,  and  many 
other  points  now  too  often  ignored  in  the  prosecution  of  unscientific  in- 
vestigations. 

Recommendations 

1.  Three  additional  police  surgeons  should  be  appointed  to  serve  as 
assistants  to  the  poHce  surgeon. 

2.  These  surgeons  should  be  employed  on  full  time. 

3.  They  should  include  in  their  duties  medical  and  surgical  attention 
to  the  suspects  and  prisoners  lodged  in  the  police  jail. 

4.  One  of  the  assistant  police  surgeons  should  be  an  expert  in  psy- 
chiatry, and  should  be  known  as  the  mental  health  officer. 

5.  The  mental  health  officer  of  the  police  department  should  serve  full 
time. 

6.  The  mental  health  officer  should  devote  his  time  to  the  mental 
problems  in  connection  with  the  police  force  and  the  police  work. 

7.  The  mental  health  officer  should  make  a  mental  and  personality 
examination  of  every  candidate  for  appointment  to  the  police  force  and 
should  record  his  findings. 

8.  Reexaminations  of  every  member  of  the  police  force  should  be 
made  by  the  surgeon  and  mental  health  officer  once  every  year. 

9.  The  mental  health  officer  should  be  present  whenever  possible  at 
all  special  examinations  of  prisoners  and  suspects,  especially  in  the  case 
of  examinations  conducted  with  the  purpose  of  obtaining  so-called  "con- 
fessions." 

Crime  Detection  by  the  Coroner's  Office 
"The  office  of  coroner  has  long  been  a  subject  of  comment  and  unfavorable 
criticism  in  this  countr3\  Phj'sicians  and  medical  societies  have  made  frequent 
efforts  to  secure  a  more  efficient  administration  of  the  duties  devolving  upon  this 
office,  baws  have  been  enacted  establishing  other  offices  as  well  as  State  boards 
and  commissions  which  have  gradual!}'  taken  away  many  of  the  duties  formerly 
belonging  to  the  coroner.  The  importance  of  the  office  has  so  decreased  that 
little  attention  is  given  by  the  political  parties  or  by  the  voters  to  the  candidates 
who  seek  election  to  the  position.  And  even  less  attention  is  given  by  the  public 
to  the  actual  administration  of  the  office  by  the  men  elected." 

Thus  begins  the  report  of  the  investigation  made  by  the  Coroner's 
Committee  of  the  Municipal  Association  of  Cleveland  in  1912,  and  in  the 
nine  years  which  have  passed  since  the  pubfication  of  this  report  prac- 
tically nothing  has  been  done  to  correct  conditions  or  to  apply  any  of  the 
recommendations  made  at  that  time.  With  minor  changes  the  report  is 
valid  today. 

I  19] 


The  office  of  coroner  in  Ohio  is  governed  entirely  by  statute.  The 
Ohio  constitution  of  1802  provided  that  one  coroner  should  be  elected  in 
each  county;  but  no  provision  for  this  office  is  contained  in  the  present 
constitution.  Under  statute  one  coroner  is  elected  in  each  county  in  the 
even-numbered  years,  who  holds  office  for  two  years  from  the  first  Mon- 
day of  the  January  following  his  election.  The  statutes  make  no  pro- 
vision for  deputy  coroners  or  other  assistants,  although  reference  is  made 
to  "the  official  assistant  of  the  coroner,"  for  whom,  however,  no  appro- 
priation is  made.  Because  of  the  advantage  of  medical  knowledge  in  this 
work  it  has  been  the  custom  to  nominate  physicians  for  the  office  of 
coroner. 

The  coroner's  chief  duty  is  to  determine  in  cases  of  sudden  or  unex- 
plained death  the  causes  of  death  and  whether  it  resulted  from  unlawful 
means,  and,  in  the  latter  case,  to  fix  responsibility  for  the  crime  and  name 
the  perpetrator.  It  is  obvious,  therefore,  that  a  consideration  of  the 
office  of  coroner  is  well  within  the  scope  of  a  survey  of  the  administration 
of  justice. 

Upon  the  proper  execution  of  the  coroner's  duties  depends,  in  no  small 
measure,  the  strict  enforcement  of  the  law  in  homicide  cases.  A  lax  per- 
formance of  these  duties,  whether  due  to  carelessness,  intentional  neglect, 
or  merely  to  ignorance,  gravely  affects  the  community.  Public  safety, 
especially  in  large  and  congested  centers  of  population,  requires  now,  as 
perhaps  never  before,  that  the  inquiry  into  the  cause  of  death  shall  be 
conducted  according  to  the  best  modern  theories  and  with  the  most  ex- 
pert knowledge  and  skill.  It  is  easy  to  simulate  an  accident  or  suicide 
and  therefore  the  definite  determination  that  violence  has  been  used 
may  be  well-nigh  impossible  unless  the  utmost  skill  and  scrupulous 
scientific  accuracy  are  brought  to  bear.  It  is  clearly  unsafe  to  trust  such 
work  to  any  but  a  highly  competent  pathologist  and  medico-legal  expert. 

The  coroner's  duties  are  given  in  the  following  excerpt  from  The 
Coroner's  Office,  Efficiency  Series,  Report  No.  2,  issued  by  the  Municipal 
Association  of  Cleveland  in  December,  1912: 

Inquests 

Tho  main  duty  of  the  coroner  is  holding  inquests.  Sections  2856  and  2857 
of  the  (ieneral  Code  provide  for  the  holding  of  inquests  and  set  forth  the  method 
of  procedure  as  follows: 

"Section  2856.  When  informed  that  the  body  of  a  person  whose  death  is 
supposed  to  have  been  caused  by  violence  has  been  found  within  the  county,  the 
coroner  shall  appear  forthwith  at  the  place  where  the  body  is,  issue  subpcenas 
for  .such  witnesses  as  he  deems  necessary,  administer  to  them  the  usual  oath,  and 
proceed  to  inquire  how  the  deceased  came  to  his  death — whether  by  violence 

[20] 


from  any  other  person  or  persons,  by  whom,  whether  as  principals  or  accessories 
before  or  after  the  fact,  and  all  circumstances  relating  thereto.  The  testimony 
of  such  witnesses  shall  be  reduced  to  writing,  by  them  respectively  subscribed, 
except  when  stenographically  reported  by  the  official  stenographer  of  the 
coroner,  and  with  the  finding  and  recognizances  hereinafter  mentioned,  if  any, 
returned  by  the  coroner  to  the  clerk  of  the  Court  of  Common  Pleas  of  the  county. 
If  he  deems  it  necessary,  he  shall  cause  such  witnesses  to  enter  into  recognizances, 
in  such  sum  as  may  be  proper,  for  their  appearance  at  the  succeeding  term  of  the 
Court  of  Common  Pleas  of  the  county  to  give  testimony  concerning  the  matter. 
The  coroner  may  require  any  and  all  such  witnesses  to  give  security  for  their 
attendance,  and  if  they  or  any  of  them  neglect  to  comply  with  his  requirements, 
he  shall  commit  such  person  to  the  prison  of  the  county,  until  discharged  by  due 
course  of  law. 

"Section  2857.  The  coroner  shall  draw  up  and  subscribe  his  finding  of 
facts  in  wTiting.  If  he  finds  that  the  deceased  came  to  his  or  her  death  by  force 
or  \'iolence,  and  by  any  other  person  or  persons,  so  charged,  and  there  present, 
he  shall  arrest  such  person  or  persons,  and  convey  him  or  them  immediately 
before  a  proper  oflftcer  for  examination  according  to  law.  If  such  persons,  or  any 
of  them,  are  not  present,  the  coroner  forthwith  shall  inform  one  or  more  justices 
of  the  peace,  and  the  prosecuting  attorney,  if  within  the  county,  of  the  facts  so 
found,  in  order  that  the  persons  may  be  immediately  dealt  with  according  to 
law." 

The  terms  used  in  Section  2856  have  been  construed  by  the  Ohio  Supreme 
Court  (62  O.S.  307)  as  follows: 

"A  death  'caused  by  violence'  is  a  death  caused  by  unlawful  means,  such 
as  usually  call  for  the  punishment  of  those  who  employ  them.  A  body  '  is  found' 
within  the  county  when  it  is  ascertained  by  any  means  that  it  is  within  the 
county." 

'"Death  is  supposed  to  have  been  caused  by  \aolence,'  whenever  from  such 
observation  as  he  may  be  able  to  make,  and  from  such  information  as  maj'  come 
to  him,  the  coroner  is,  for  reasons  of  substance,  led  to  surmise  or  think  that  death 
has  been  so  caused." 

As  thus  interpreted  by  the  Supreme  Court,  the  statute,  in  referring  to  "death 
by  violence,"  means  intentional  killing  as  distinguished  from  mere  negligence. 
No  criminal  negligence  act  has  thus  far  been  passed  in  Ohio,  and  the  terms  of 
the  present  statute  are  certainly  not  intended  to  confer  general  jurisdiction  upon 
the  coroner  in  cases  of  accidental  deaths  by  railroads,  street  cars,  in  manufactur- 
ing plants  and  the  like,  except  in  cases  where  death  is  supposed  to  have  been 
caused  by  "unlawful  violence"  and  not  mere  negligence. 

However,  there  is  one  exception  to  the  general  rule,  namely,  that  Sees.  926-7 
seem  to  require  the  coroner  to  hold  inquests  in  all  reported  cases  of  fatalities 
occurring  by  explosion  or  accident  connected  with  a  mine,  regardless  of  the 
question  of  criminality.  Moreover,  the  statutes  now  provide  (Sees.  212-3)  that 
in  cases  of  death  occurring  without  medical  attendance  it  shall  be  the  duty  of 

[21] 


the  undertaker  to  notify  the  registrar  of  vital  statistics  of  such  death  and,  if 
such  death  appears  to  the  registrar  to  have  been  caused  by  unlawful  or  suspicious 
means,  he  shall  refer  the  case  to  the  coroner  for  inquest. 

The  statutes  further  provide  (Sees.  6268-9),  in  cases  where  the  death  of  an 
inmate  of  a  licensed  maternity  boarding-house  or  lying-in  hospital  is  reported 
to  the  board  of  health,  that  such  board  of  health  shall  forthwith  call  upon  the 
coroner  to  hold  an  inquest  unless  the  certificate  of  a  legally  qualified  physician 
is  exhibited  specifying  the  cause  of  death. 

The  practical  effect  of  Sec.  2856,  giving  the  coroner  jurisdiction  to  act  in  cases 
where  "death  is  supposed  to  have  been  caused  by  violence"  is  to  make  it  dis- 
cretionary' with  the  coroner  in  what  cases  he  shall  act;  and  renders  it  practically 
outside  the  power  of  the  courts  to  regulate  the  actions  of  the  coroner  in  this 
regard.  The  language  of  this  section  is  so  broad  that  the  extent  of  the  coroner's 
authority  is  left  almost  wholly  to  his  discretion  and  good  faith;  and  any  criticism 
of  his  having  a.ssumed  jurisdiction  unnecessarily  could  be  met  with  the  general 
rule  that  a  public  officer's  acts  are  presumed  to  be  according  to  law  and  in  good 
faith.  In  brief,  the  coroner  is  his  own  guide  as  to  the  number  of  inquests  he  will 
hold. 

Autopsies 

The  statutes  provide  (Sec.  2495)  that  "The  county  commissioners  may  allow 
a  physician  or  surgeon,  making  a  postmortem  examination  at  the  instance  of  the 
coroner  or  other  officer,  such  compensation  as  they  deem  proper."  Although  the 
coroner  may  determine  in  what  cases  autopsies  shall  be  performed,  and  who  shall 
p>erform  them,  the  commissioners  thus  have  entire  discretion  as  to  compensation, 
and  in  practice  their  wishes  largely  control  as  to  the  kinds  of  cases  in  which 
autopsies  shall  be  made.  Autopsy  fees  and  the  relative  number  of  autopsies 
performed  vary  greatly,  therefore,  in  different  counties. 

Formerly  in  Cuyahoga  County  the  coroner  distributed  the  autopsies  among 
favored  physicians  or  hospital  internes.  Under  the  present  administration  the 
coroner  has  assigned  this  work  to  his  "deputy,"  Dr.  Droege,  and  under  an  agree- 
ment between  the  county  commissioners  and  Dr.  Droege  he  performs  all  autop- 
sies at  a  uniform  charge  of  $15  and  confines  his  examinations  to  cases  of  supposed 
homicidal  death. 

Further  Duties 

Where  the  coroner  attends  upon  the  body  of  a  deceased  person  it  is  his  duty 
(Sec.  2860)  to  notify  friends  or  relatives  of  the  deceased  if  known,  or  if  not  known, 
to  advertise  the  fact  of  death  in  a  newspaper. 

He  is  required  (Sees.  2859  and  2861)  to  make  an  inventory  of  all  articles  of 
property  found  on  or  about  the  body,  and  to  return  the  inventory  (Sees.  2861-3) 
and  the  articles  described  therein  to  the  Probate  Court,  where  such  property 
other  than  money  becomes  subject  to  the  order  of  the  Probate  Court,  for  its 
pre.servation  or  other  disposition,  the  rights  of  administrators  and  executors 
(Sec.  2684)  being  fully  recognized.  The  statute  directs  that  such  property  (Sec. 
2863)  as  is  unidentified  or  unclaimed  shall  be  advertised  and  sold  at  public  sale 

[22] 


annually  by  the  Probate  Court  and  the  proceeds  paid  into  the  county  treasury. 
However,  money  found  shall  be  applied  first  (Sec.  2S62)  to  paying  the  expenses 
of  saving  the  body,  and  of  the  inquest  and  burial,  and  the  remainder  shall  be 
paid  into  the  county  treasury,  where,  on  proper  proof  being  offered,  such  money 
as  well  as  the  proceeds  of  property  sold  shall  be  paid  over  to  the  claimant  entitled 
to  it. 

Anomalous  Duties  of  Ohio  Coroners 

In  addition  to  the  duties  which  it  would  seem  properly  belong  to  the  office 
of  coroner,  he  is  bj'  statute  in  Ohio  made  a  process  server,  both  for  the  Common 
Pleas  Court  (Sec.  2835),  where  the  sheriff  is  an  interested  party,  and  for  the 
Probate  Court  (Sees.  1596  and  1599),  generally,  and  in  certain  cases  (Sec.  11435) 
he  may  further  be  called  on  for  summoning  a  jury.  Moreover,  he  is  given  the 
additional  duties  (Sec.  13606)  of  endeavoring  to  arrest  convicts  escaping  from  the 
penitentiar>',  and  (Sec.  9914)  of  apprehending  persons  selling  liquor  contrary  to 
law  within  two  miles  of  the  place  where  an  agricultural  fair  is  being  held. 

In  all  these  latter  cases  he  is  assigned  duties — although  his  ser\'ices  in  such 
instances  are  extremely  rare — which  are  already  enjoined  upon  other  officers 
by  law,  or  for  the  performance  of  which  the  courts  are  given  the  power  to  make 
special  appointments  in  case  of  need.  These  special  duties  are  clearly  a  survival 
of  the  days  when  deputy  sheriffs  were  a  rarity  and  when  the  oflSce  of  coroner  was 
not  regularly  filled  by  a  practising  physician. 

Compensation 
The  coroner's  office  is  the  only  office  still  maintained  on  a  fee  basis.    His 
remuneration  for  his  services  is  dependent  entirely  upon  fees  earned,  the  amounts 
of  which  are  scheduled  (Sec.  2866)  as  follows: 

(a)  For  viewing  a  dead  body,  three  dollars. 

(b)  For  all  necessary  wTitings  and  the  return  thereof,  10  cents  per  100 
words. 

(c)  For  traveling  to  the  place  of  view,  10  cents  per  mile. 

No  special  fee  is  provided  for  the  hearing  of  testimony  in  connection  with 
inquests,  and  the  coroner's  compensation  in  such  cases,  other  than  the  fee  for 
viewing  the  body,  is  dependent  on  the  allowances  for  necessary  wTitings  con- 
nected with  making  up  the  records  from  the  testimony  and  the  other  incidents 
of  the  case.  The  statutes  do  not  contemplate  the  making  of  autopsies  by  the 
coroner  in  person  and  no  fee  is  specified  for  this  work. 

The  .staff  of  the  coroner  is  appointed  by  the  county  commissioners, 
the  tenure  of  office  being  subject  to  their  pleasure.  The  staff  is  under 
the  jurisdiction  of  the  coroner,  although  he  has  no  authority  to  discharge 
individuals.  There  is  little  interest  in  the  election  of  the  coroner,  the 
name  of  the  nominee  appearing  usually  at  the  end  of  the  ballot. 

The  coroner  receives  no  specified  salary,  his  compensation  being  de- 
pendent on  the  collection  of  fees,  the  only  county  office  still  thus  main- 

[23] 


tained.  For  viewing  a  dead  body  he  receives  a  fee  of  $3.00,  no  matter 
where  the  bodj'-  maybe  located  nor  the  length  of  time  consumed  in 
reaching  it.  For  traveling  expenses  10  cents  per  mile  is  allowed.  The 
statutes  do  not  provide  special  fees  for  the  performance  of  autopsies  by 
the  coroner.  As  a  matter  of  practice,  the  county  commissioners  allow  a 
fee  of  S25.  There  is  no  specified  fee  provided  for  the  taking  of  testimony 
at  inquests,  compensation  for  this  depending  upon  the  allowance  for  the 
necessary  clerical  work.  There  is  no  provision  for  extra  fees  and  no 
allowance  to  meet  the  expenses  in  especially  complicated  cases.  Salaries 
and  wages  for  the  staff  are  as  follows:  morgue  keepers,  $137.50  per 
month;  janitors,  $110. 

The  present  coroner  of  Cuyahoga  County,  A.  P.  Hammond,  M.D., 
has  been  in  office  since  January,  1921.  Dr.  Hammond  has  been  a  prac- 
tising physician  and  still  devotes  some  time  to  general  practice.  He  keeps 
daily  office  hours  at  the  Morgue,  from  8.30  to  12  and  from  1  to  3  o'clock. 
All  who  have  come  in  contact  with  Dr.  Hammond  are  unanimous  in  their 
commendation  of  his  serious  attitude  toward  his  work  and  his  desire  to 
cooperate  in  every  way.  The  community  is  fortunate  in  having  such  an 
officer  in  this  very  important  position,  especially  in  view  of  the  anti- 
quated conditions  under  which  this  work  is  being  performed  in  Cuyahoga 
County. 

The  statutes  lay  down  no  requirements  for  the  office  of  coroner  except 
that  he  must  not  practise  as  an  attorney  or  counselor-at-law. 

The  present  practice  in  the  coroner's  office  in  regard  to  stenographic 
service  is  to  secure  a  stenographer  from  a  typewriter  company  on  the 
authority  of  the  county  prosecutor.  A  fee  of  10  cents  per  100  words  is 
all  the  compensation  available,  although  this  sum  appears  to  be  less  than 
the  salary  of  a  regular  full-time  stenographer.  It  has  been  the  practice 
in  the  past  for  the  coroner  to  employ  a  stenographer  at  his  own  expense. 

Autopsies  are  performed  by  physicians  selected  by  the  coroner  for  this 
duty.  As  a  rule,  a  qualified  pathologist  has  been  employed  for  this  work. 
For  this  reason  practically  all  the  autopsy  work  has  been  of  a  high  order, 
a  circumstance  which  is  all  the  more  fortunate  since  it  is  due  to  the  good 
judgment  of  the  coroner,  rather  than  to  the  provisions  of  the  law. 

There  arc  four  morgue  keepers  and  two  janitors.  One  of  the  morgue 
keepers  serves  as  a  clerk,  keeping  and  filing  the  records.  He  assists  at 
autopsies  and  acts  as  coroner  when  the  latter  is  absent.  The  present  in- 
cumbent was  formerly  an  undertaker  and  expert  embalmer.  He  has  held 
his  present  position  for  eight  years.  The  other  three  morgue  keepers  do 
general  utility  work,  such  as  answering  the  telephone,  taking  messages, 
receipting  for  property  and  money  found  on  bodies  brought  in  by  .the 

[24  1 


police,  making  entries  in  property  books,  etc.  They  work  eight  hours  a 
day,  seven  days  a  week,  as  the  morgue  is  never  closed.  No  bond  is  re- 
quired and  no  special  qualifications  are  named  for  these  positions.  How- 
ever, the  feeling  among  the  morgue  keepers  is  that  they  should  be  licensed 
and  bonded  and  that  a  qualification  for  this  position  should  be  experience 
as  a  licensed  embalmer,  especially  on  account  of  the  possible  danger  to 
the  community  of  careless  handling  of  the  bodies  of  persons  who  have 
died  of  contagious  disease. 

The  two  janitors  are  responsible  for  caring  for  the  two  floors  of  the 
morgue.  One  of  the  janitors  serves  as  relief  man  to  give  the  morgue 
keepers  one  da\^  off  a  week.  The  morgue  keepers  and  janitors  are  ap- 
pointed and  paid  by  the  county  commissioners.  The  discipline  is  not 
good,  and  the  staff,  as  might  be  expected  under  the  conditions,  lacks 
esprit  de  corps.  On  account  of  the  valuables  and  other  property  which  is 
continuously  passing  through  the  morgue,  the  staff  must  often  find  them- 
selves in  positions  where  their  honesty  may  be  questioned,  a  circum- 
stance which  further  tends  toward  bad  morale  and  consequently  lessened 
efficiency  in  the  service. 

In  addition  to  the  above,  there  is  a  special  constable  attached  to  the 
coroner's  office  who  serves  the  necessary  legal  papers  in  subpoenaing 
witnesses.  This  ofiicer  is  allowed  considerable  discretion  in  deciding 
which  witnesses  to  subpoena.  Usually  the  selection  depends  entirely 
upon  his  judgment.  The  fee  for  this  work  is  paid  by  the  county  treasurer 
through  the  auditor,  and  the  total  sum  varies  considerably  in  amount  in 
a  year.  It  is  said  that  formerly  considerable  sums  were  paid  over  annu- 
ally for  such  service. 

1.  Relation  to  Police 

The  Division  of  Police  sends  the  coroner  a  copy  of  its  reports  on 
criminal  cases.  The  coroner  also  makes  a  report  to  the  police  of  all  cases 
coming  to  his  notice.  If  a  dead  body  is  discovered  in  surroundings  indi- 
cating violence,  the  police  assume  responsibility  for  all  weapons  and 
other  objects  which  might  serve  as  evidence  and  exhibits.  The  coroner 
takes  possession  of  the  body  and  personal  belongings.  The  police  later 
turn  over  to  the  prosecutor  all  property  in  their  possession. 

The  police  emergency  or  ambulance  conveys  bodies  to  the  morgue  in 
practically  all  cases.  This  has  become  the  custom  only  of  late,  since  the 
poUce  emergency  has  superseded  the  old  ambulance  service  which  used 
to  be  in  the  hands  of  undertakers.  Occasionally  bodies  are  brought  to 
the  morgue  in  undertakers'  wagons.  A  policeman  accompanies  the  body 
and  makes  a  list  of  the  clothing  and  property  found.    The  morgue  keeper 

(25  1 


makes  an  examination  of  the  clothing  of  the  corpse  in  the  presence  of  the 
poHce  officer,  making  an  inventory  of  all  property  found,  and  an  entry 
in  the  property  book  which  the  policeman  signs  as  a  witness.  There  is 
thus  a  double  check  on  all  property. 

In  murder  or  suspected  murder  cases  the  clothing  is  put  in  a  bag  and 
kept  in  the  morgue,  available  for  use  in  evidence.  In  criminal  cases 
clothing  and  property  are  released  to  relatives  only  on  order  of  the 
prosecutor.  Bullets  taken  from  bodies  are  carefully  preserved  and  im- 
portance is  attached  to  the  necessity  of  proving  that  the  bullet  submitted 
as  evidence  was  actually  the  one  taken  from  the  body.  Some  years  ago 
a  case  occurred  in  which  a  person  indicted  for  murder  was  not  convicted 
because  of  careless  handling  of  the  evidence,  which  in  this  instance  was  a 
bullet.  In  the  case  of  bodies  which  are  in  an  unidentifiable  condition,  due 
to  exposure  or  long  immersion  in  water,  or  to  trauma,  the  skill  of  the 
expert  embalmer  has  proved  of  value  to  the  morgue  by  so  restoring  the 
bodies  that  identification  was  possible. 

In  manslaughter  and  murder  cases  police  officers  or  detectives  are 
present  at  the  autopsies.  There  is  naturally  a  great  deal  of  cooperation 
between  the  coroner's  office  and  the  police  in  detecting  crimes,  evidence 
often  being  obtained  in  the  morgue  in  regard  to  the  exact  cause  of  death, 
the  nature  of  the  weapon  used,  and  many  other  details  which  prove  of 
value  to  the  criminal  detective  agencies.  The  police  sometimes  bring 
suspects  to  the  morgue  for  "third  degree"  purposes,  suddenly  confront- 
ing the  suspect  with  the  body  of  the  victim. 

2.  Relation  to  Courts 

The  coroner  and  his  assistants  have  relations  with  the  Municipal 
Court,  the  grand  jury,  the  Common  Pleas  Court,  and  the  Probate  and 
Juvenile  Court. 

The  coroner  or  his  assistants  are  subject  to  call  as  witnesses  in  the 
Municipal  Court  before  the  cases  are  bound  over  to  the  grand  jury.  The 
coroner  testifies  before  the  grand  jury,  submitting  for  its  use  copies  of  the 
report  of  the  autopsy  and  the  inquest.  In  all  Common  Pleas  Courts  the 
coroner  or  his  assistants  testify  in  murder  cases.  The  present  coroner 
is  of  the  opinion  that  this  testimony  would  be  of  more  value  if  the  coroner 
himself  performed  the  autopsy.  The  coroner,  as  well  as  all  the  assistants 
and  employees,  are,  of  course,  subject  to  subpoena  in  court  to  prove  corpus 
delicti. 

The  Probate  Court  law  of  1920  makes  the  coroner  custodian  of  all 
property  in  coroners'  cases.  All  unclaimed  money  is  held  for  a  year  and 
then  turned  over  to  the  Probate  Court.    A  property  list  is  made. and 

[26] 


must  be  filed  by  the  morgue  keeper  and  the  coroner.  Property  of  any 
amount  or  value  may  be  released  to  relatives  or  other  claimants  upon 
order  by  the  Probate  Court.  If,  however,  the  property  is  of  considerable 
value,  it  is  turned  over  to  an  especially  appointed  administrator.  The 
order  from  the  Probate  Court  releasing  property  is  carefully  filed  at  the 
morgue  in  the  property  book. 

The  relations  of  the  coroner  to  the  Juvenile  Court  are  of  little  impor- 
tance, as  the  coroner  and  his  assistants  are  rarely  called  upon  to  appear  in 
this  court. 

3.  Relation  to  Prosecutors 

The  nature  of  the  coroner's  duties  and  functions  necessitates  much 
contact  with  the  prosecutor's  office.  The  effectiveness  of  the  service  is 
somewhat  influenced,  therefore,  by  the  personal  relations  existing  be- 
tween these  officers.  The  present  coroner  and  the  city  prosecutors  are  on 
friendly  terms,  and  as  a  result,  cooperate  satisfactorily.  The  county 
prosecutor  decides  in  which  cases  to  hold  autopsies.  A  representative  of 
the  county  prosecutor's  office  is  usually  present  to  assist  in  coroner's 
inquests.  The  coroner  and  his  assistants  are  often  called  to  the  poUce 
station  to  give  information  regarding  the  bodies  and  to  aid  the  police  in 
preparing  cases.  During  the  trial  they  are  often  called  upon  to  testify  in 
court.  The  coroner  and  his  assistants  are  called  in  by  the  prosecutor  to 
establish  the  cor-pus  delicti  and  to  bind  the  prisoners  over  to  the  grand 
jury. 

Jf.  Relation  to  the  Bar 

Lawyers  acting  as  counsel  in  both  civil  and  criminal  actions  may  come 
to  the  morgue  for  information  or  evidence.  A  lawyer  may  attend  the 
coroner's  inquests  and  may  question  witnesses,  but  cannot  enter  objec- 
tions. 

5.  Relation  to  the  Medical  Profession 

Physicians  report  to  the  coroner  cases  of  sudden  death,  usually  by 
telephone.  The  coroner  then  decides  whether  or  not  to  claim  the  case. 
When  the  coroner  decides  not  to  assume  jurisdiction,  the  physician  may 
perform  the  autopsy  himself,  either  at  the  morgue  or  at  his  own  oflBce. 

6.  Administrative  Relations 
The  coroner  issues  certificates  to  undertakers  through  the  Board  of 
Health.  Sometimes  the  district  phj'sicians  feel  they  cannot  issue  death 
certificates  because  of  suspicious  circumstances,  and  so  report  to  the 
Board  of  Health,  which  in  turn  reports  to  the  coroner.  The  city  chemist 
analyzes  stomach  contents,  secretions,  and  excretions  obtained  from  the 
body  in  suspicious  cases.    In  all  cases  of  death  occurring  without  medical 

127] 


attendance  within  the  city  Hmits  the  district  physician  may  view  the 
body  and  report  "Cause  of  death  unknown."  In  cases  of  sudden  death 
without  medical  attendance  occurring  in  the  county  outside  of  the  city 
of  Cleveland,  the  sheriff  performs  the  functions  which,  within  the  city 
limits,  are  performed  by  the  police.  He  notifies  the  coroner  when  such 
cases  are  found,  and  accompanies  the  coroner  to  the  bodj'.  The  sheriff 
takes  the  weapons  and  all  suspicious  objects;  the  coroner  claims  the 
body  and  the  property  on  it.  In  the  case  of  probable  suicide  the  coroner 
also  takes  possession  of  the  gun  or  other  weapon. 

The  county  commissioners  "O.  K."  all  bills  of  expense  of  the  coroner's 
office.  There  is  no  supervision  of  the  county  work.  At  present  both  the 
municipal  and  county  administration  are  Republican.  One  of  the  morgue 
keepers  who  is  a  Democrat  stated  to  the  investigator  that  there  are  no 
pohtical  troubles. 

The  present  coroner  is  on  friendly  terms  with  the  county  prosecutor. 
They  cooperate  in  inquests  and  in  other  activities  connected  with  their 
duties.  This  has  not  always  been  the  situation,  and  difficulties  have  oc- 
curred because  of  strained  relations  between  coroner  and  prosecutors. 

7.  Equipment 

The  public  morgue  was  created  by  special  statute  passed  in  1896  (92 
Ohio  Laws,  678).  It  was  placed  in  care  of  the  coroner,  who  is  directed  to 
see  that  all  dead  bodies  received  are  properly  preserved  until  identified  or 
claimed  for  bm-ial;  to  collect  from  friends  or  relatives  of  such  deceased 
persons  not  residing  in  the  county  a  sum  not  to  exceed  $10;  and  to  have 
photographed  all  bodies  not  properly  identified. 

The  morgue  occupies  a  two-story  building.  On  the  first  floor  are  the 
oflSce  of  the  morgue  keeper  and  a  safe  for  property,  a  well-equipped 
autopsy  room,  and  a  viewing  hall.  The  morgue  has  capacity  for  100 
bodies  at  a  time.  This  space  is  arranged  in  four  sections,  the  first  of 
which  only  is  cooled  by  refrigeration,  because  of  the  fact  that  it  is  easier 
to  embalm  bodies  which  have  not  been  frozen.  Hence  most  of  the  bodies 
are  kept  in  the  non-refrigerated  sections.  On  the  second  floor  are  the  coro- 
ner's office,  a  safe  for  property,  and  the  office  of  the  assistant  clerk,  a  well- 
appointed  inquest  room,  and  files  and  records  which  go  back  to  1828. 
These  files  and  records  are  kept  in  the  inquest  room.  The  filing  cabinets 
contain  the  following  data  in  each  case:  viewing  sHp,  inquest  slip,  a 
carbon  copy  of  the  police  report  of  criminal  cases,  testimony  of  witnesses, 
and  the  autopsy  records,  all  filed  together  in  a  folder. 


[281 


8.  Death  Records 

Only  the  knowledge  that  we  are  dealing  with  a  very  serious  subject 
prevents  us  from  treating  in  a  lighter  vein  some  of  the  results  of  the  coro- 
ner's work  as  performed  under  present  conditions.  Indeed,  we  cannot 
entirely  suppress  a  sense  of  the  ridiculous  when  we  read  over  the  list  of 
causes  of  death  as  officially  recorded  by  the  coroner  of  Cuyahoga  County 
for  the  year  1919. 

The  first  entry  for  the  year  is: 

No.  22942 :  "  Could  be  suicide  or  murder,"  a  reassuring  statement  and 
one  calculated  to  promote  confidence  in  the  guardians  of  public  safety. 

Again  a  few  lines  further  along  we  read:  No.  22957 — "Auto  accident 
or  assault."  Certainly  this  expresses  a  doubt  which  the  public  would  be 
interested  to  have  resolved  further. 

No.  23178:  "Aunt  said  she  complained  of  pneumonia,  looked  Hke 
narcotism."  Is  it  necessary  to  dwell  on  the  extraordinary  convenience  of 
having  the  subject  thus  obligingly  perform  the  work  of  the  coroner  by 
confiding  the  diagnosis  and  thus  settling  at  the  same  time  the  cause  of 
subsequent  demise? 

No.  23203:  "Believe  strychnia  used — viewed  as  suicide."  Is  it  not 
possible  to  know  whether  strychnia  was  or  was  not  used? 

No.  23241:  "Looks  suspicious  of  strychnine  poisoning,"  and  this 
suspicion  must  forevermore  poison  the  mind  of  anyone  who  turns  the 
pages  of  the  coroner's  record  because  the  county  of  Cuyahoga  did  not  be- 
lieve it  important  to  know  whether  this  was  a  case  of  homicide,  suicide,  or 
an  accident. 

Consider  from  the  point  of  view  of  law  enforcement  and  the  public 
safety  such  records  as  these: 


No.  22964 
No.  22987 
No.  22990 
No.  23035 
No.  23050 
No.  23135 
No.  23187 
No.  23253 
No.  23300 
No.  23484 
No.  23512 
No.  23551 
No.  23568 
No.  23574 


'Found  dead." 
'Found  dead  in  shanty." 
'Head  severed  from  body." 
'Could  be  assault  or  diabetes." 
'Premature  or  abortion." 
'Found  dead  in  alley — lobar  pneumonia." 
'Diabetes,  tuberculosis,  or  nervous  indigestion." 
'Consider  it  tuberculosis." 
'Found  dead." 
'Found  crushed." 
'Could  be  diabetes  or  poison." 
'Died  suddenly  after  taking  medicine." 
'Medicinal  poisoning." 
'Body  entirely  burned." 
129] 


No.  23577 
No.  23605 
No.  23670 
No.  23686 
No.  23687 
No.  23731 


"Found  dead  in  bath-room." 

"Died  suddenly." 

"Loss  of  blood." 

"Shock." 

"Body  covered  with  sores." 

"Acute  arsenical  poisoning-accident." 


In  none  of  these  cases  was  an  autopsy  performed,  although  one  would 
suppose  that  in  some,  if  not  in  all,  more  precise  information  is  needed  not 
onlj'  to  determine  the  exact  cause  of  death,  but  definitely  to  exclude 
foul  play. 

9.  Cost  of  Administration 

The  apparent  cost  of  administration  of  the  coroner's  office  appears  to 
be  about  one-half  what  it  was  in  1912.  The  scattering  of  items  through- 
out the  county  work  makes  it  impossible  to  be  exact,  but  it  is  safe  to 
assume  that  the  entire  cost  of  administration,  including  the  morgue  and 
numerous  miscellaneous  items,  is  between  S10,000  and  S15,000  annually.^ 

REPORT  OF  AUDITOR'S  OFFICE  OF  CUYAHOGA  COUNTY  ON  THE 
EXPENSE  OF  THE  CORONER'S  OFFICE 


September, 
1912 

September, 
1919 

September, 
1920 

Coroner's  fees 
Constable's  fees 
Witness'  fees 
Autopsy  fees 
Miscellaneous 

86,101.75 

1,585.30 

1,801.90 

1,155.00 

127.61 

84,629.10 

14.40 
1,290.00 

81,876.82 

5.50 

12.60 

2,760.00 

44.55 

Totals 

$10,771.56 

85,933.50 

$4,699.47 

Even  a  cursory  glance  at  the  foregoing  suffices  to  show  that  the  work 
of  coroner  as  now  performed  is  far  from  adequate.  It  is  indeed  high  time 
that  the  facts  are  faced  and  an  effective  arrangement  commensurate  with 
modern  scientific  efficiency  be  instituted. 

This  means  abolishing  the  office  of  coroner. 

10.  The  Remedy 
During  the  recent  (1921)  session  of  the  Ohio  Legislature  a  bill  was  in- 
troduced through  the  efforts  of  the  present  coroner  of  Cuyahoga  County, 
Dr.  A.  P.  Hammond,  which  was  designed  to  meet  some  of  the  objections 

'  The  budget  for  the  office  of  chief  medical  examiner  of  New  York  for  the  year 
1921  is  $127,.303,  of  which  $120,653  is  for  salaries  and  wages. 

130  1 


without  abolishing  the  office  of  coroner.  This  bill  allows  the  coroner,  in 
counties  having  a  population  of  100,000  or  more,  to  appoint  an  official 
stenographer,  and  "in  counties  where  there  is  maintained  a  county 
morgue,  the  coroner  may  also  appoint  necessary  assistant  custodians  of 
the  morgue,  in  no  case  to  exceed  three  in  number."  Above  all,  in  counties 
having  a  population  of  100,000  or  more,  "no  person  shall  be  eligible  to  the 
office  of  coroner  except  a  licensed  physician  of  good  standing  in  his  pro- 
fession." 

The  principal  objections  to  this  bill  are: 

1.  That  the  coroner  is  elected  and  not  appointed.  Keeping  the  office 
in  pohtics  makes  it  impossible  to  secure  the  quality  of  service  required. 
No  competent  expert  can  be  induced  to  subject  his  work  or  his  profes- 
sional career  to  the  uncertainties  of  partisan  pohtics.  Continuity  of  ser- 
vice and  freedom  from  extraneous  interference  are  the  sine  qua  non  of 
scientific  efficiency. 

2.  That  the  decision  whether  or  not  to  perform  an  autopsy  rests  not 
with  the  coroner,  but  with  the  prosecuting  attorney.  This  most  perni- 
cious custom  makes  the  scientific  determination  of  the  cause  of  death 
subservient  to  the  requirements  of  the  prosecutor's  office  and  dependent 
upon  the  state  of  his  finances,  instead  of  regarding  such  determination  as 
a  complete  end  in  itself,  the  results  to  be  used  in  whatever  way  may  be 
considered  proper  by  the  prosecutors  or  anyone  else. 

3.  That  the  coroner  should  be  a  physician,  but  not  necessarily  experi- 
enced in  pathology.  It  is  amply  demonstrated  by  the  history  of  the  coro- 
ner's office  in  Cuyahoga  County  that  securing  a  physician  as  coroner  does 
not  in  itself  constitute  a  sufficient  safeguard  against  unsatisfactory  results. 

In  1877  the  General  Court  of  Massachusetts  abolished  the  coroner 
and  created  in  his  place  a  medical  examiner.^  Dr.  George  Burgess 
Magrath,  medical  examiner  of  Suffolk  County,  Massachusetts,  has 
kindly  furnished  the  following  statement  in  regard  to  the  Massachusetts 
law  and  its  functioning: 

The  Massachusetts  Medical  Examiner  Law  was  enacted  in  1877.  It  abol- 
ished the  office  of  coroner,  assigned  to  physicians  appointed  by  the  governor  all 
of  the  responsibilities  involved  in  the  investigation  of  the  cause  and  manner  of 
deaths  supposedly  due  to  injury,  and  delegated  to  justices  of  courts  of  first  in- 
stance the  magisterial  function  of  fixing  the  responsibility  for  a  death  due  to 
an  unlawful  act.  The  only  important  modification  of  the  original  statute  is  one 
made  a  few  years  ago  by  an  amendment  which  substituted  for  the  word  "vio 
lence"  the  words  "act  or  negligence  of  another"  in  that  portion  of  the  law 
governing  inquests. 

'  The  Massachusetts  law  is  appended. 
[31] 


The  statute  is  not  highly  specific  in  its  definition  of  the  jurisdiction  of  a 
medical  examiner,  in  that  it  merely  provides  for  his  functioning  in  the  case  of 
death  of  any  person  "supposed  to  have  come  to  his  death  from  violence."  The 
interpretation  of  this  statute  by  the  medical  examiners  of  the  commonwealth  is, 
however,  such  as  to  extend  its  provisions  to  include  all  deaths  caused  directly  or 
indirectly  by  traumatism,  including  traumatic  septicemia,  deaths  caused  by  the 
action  of  chemical  substances,  of  thermal  or  electrical  agencies;  deaths  fol- 
lowing abortions,  irrespective  of  circumstances;  deaths  from  disease  resulting 
from  injury  or  infection  relating  to  occupation;  deaths  from  neglect;  sudden 
deaths  of  persons  not  disabled  by  recognized  disease;  and  the  deaths  of  persons 
found  dead.  This  interpretation  is,  of  course,  necessary  in  order  to  make  the 
law  of  any  practical  value,  and  brings  within  the  scope  of  its  operation  deaths 
universall}'^  recognized  as  appropriate  for  medico-legal  inquiry. 

The  principal  advantages  of  the  Massachusetts  type  of  medico-legal  inquiry 
over  the  coroner  system  are  as  follows: 

(1)  The  separation  of  medical  and  judicial  functions  and  the  delegating  of 
each  to  appropriate  officials. 

(2)  The  giving  to  the  medical  investigator  the  primary  and  full  jurisdiction 
over  the  body  of  the  decedent,  thereby  insuring  to  him  ample  opportunity  to 
observe  conditions  or  circumstances  tending  to  show  the  manner  as  well  as  the 
cause  of  death.  These  often  include  facts  susceptible  of  recognition  and  proper 
interpretation  by  a  medical  examiner  only. 

(3)  The  economy  incidental  to  the  use  of  existing  courts  which  dispenses 
with  the  coroner's  court  and  jury. 

(4)  The  placing  where  it  belongs,  in  the  hands  of  a  medical  man,  the  duty  of 
determining  promptly  the  cause  of  death,  whereby  crimes  against  life  may  be 
immediately  brought  to  light  and  the  appropriate  judicial  and  police  authorities 
notified  thereof;  whereby  also  deaths  from  injury  other  than  that  incidental  to 
the  act  or  negligence  of  another,  as  well  as  deaths  from  so-called  natural  causes, 
may  be  recognized  as  such  with  equal  promptness,  without  unnecessary  pub- 
licity, and  without  the  use  and  incidental  expense  of  a  court  or  coroner's  jurj'. 

(5)  The  opportunity  existent  is  an  appointive  position  of  selecting  therefor 
physicians  qualified  by  special  training  and  experience. 

Dr.  Charles  Norris,  Chief  Medical  Examiner  of  New  York  city,  under 
the  recently  enacted  law  of  New  York^  abolishing  the  coroner  and  estab- 
lishing the  office  of  chief  medical  examiner,  has  thus  summed  up  his  expe- 
riences and  conclusions:'^ 

General  dissatisfaction  with  the  work  of  the  coroner  of  the  city  of  New  York 

'  Laws  of  New  York,  191.5,  Chap.  285.  "An  act  to  amend  the  Greater  New  York 
Charter  and  repeal  certain  sections  thereof."  (See  also:  Laws  of  New  York,  1882. 
Chap.  410.) 

*"The  Medical  Examiner  versus  the  Coroner,"  by  Charles  Norris,  M.D.,  Na- 
tional Municipal  Reiiew,  Vol.  IX,  No.  8,  August,  1920. 

132] 


resulted  in  many  attempts  in  the  legislature  at  Albany  to  abolish  this  office  and 
to  substitute  an  office  to  be  known  as  medical  examiner,  after  the  fashion  of  that 
created  many  years  before  in  Massachusetts,  f'inally  on  April  14,  1915,  the 
office  of  the  coroner  was  abolished  and  in  its  place  the  office  of  chief  medical 
examiner  was  established. 


The  Coroner's  Office  Breaks  Down 

Unlike  the  coroner's  office,  the  medical  examiner's  office  was  not  given  quasi- 
judicial  powers,  but  was  vested  with  sufficient  authority  to  administer  oaths 
and  take  affidavits,  proofs,  and  examinations  as  to  any  matter  within  the  juris- 
diction of  the  office.  The  judicial  functions  formerly  vested  in  the  coroners 
were,  under  the  medical  examiner's  act,  transferred  to  the  proper  legal  authori- 
ties, namely,  the  magistrates  and  the  grand  jur}'.  Prisoners  are  now  held  by  the 
magistrates,  and  the  defendants  are  indicted  by  the  grand  jury  upon  presentation 
of  the  facts  by  the  district  attorney  from  the  reports  furnished  by  the  medical 
examiner,  the  police  and  witnesses. 

The  judicial  functions  of  the  coroner's  office  are  now  more  satisfactorily  and 
quickly  handled  bj'  the  legally  trained  magistrates  and  by  the  grand  jury  under 
the  guidance  of  the  district  attorney.  In  other  words,  the  judicial  functions  of 
the  coroner's  office  are  redundant  and  have  no  proper  place. 

The  correct  determination  of  the  cause  of  death  is  designated  as  medical 
jurisprudence,  the  science  which  correlates  our  medical  knowledge  to  the  purpose 
of  the  law\  Thorough  equipment  in  medicine  and  surgery  must  be  supple- 
mented by  a  knowledge  of  firearms,  the  efTect  of  bullets  on  the  human  body, 
recognition  of  powder  marks  and  burns,  etc.  Familiarity  with  the  biological 
methods  employed  in  testing  suspected  blood,  semen,  and  other  stains;  prac- 
tical knowledge  of  botany  in  the  examination  of  dust  and  foreign  material  upon 
the  clothes  of  suspects  and  in  the  examination  of  the  intestinal  contents  for  parti- 
cles of  food,  that  is,  plant  seeds  and  fibers  of  animal  and  vegetable  origin;  an 
acquaintance  with  the  flora  and  fauna  of  waters,  namely,  diatoms,  etc.,  may  be 
of  great  assistance  in  the  microscopic  examination  of  the  contents  of  the  lungs 
and  stomach  of  persons  supposed  to  have  been  drowned;  and  again,  the  de- 
termination of  the  freezing-point  and  the  differences  in  the  salt  content  between 
the  blood  of  right  and  left  side  of  the  heart  may  be  of  use  to  confirm  or  negate 
the  diagnosis  of  drowning.  Entomolog>'  also  may  be  of  considerable  assistance 
in  establishing  the  date  of  death  through  the  cadaveric  flora  and  fauna. 

This  incomplete  summary  of  the  duties  of  the  pathological  expert  serves  to 
emphasize  the  point  I  wish  to  make.  That  the  officer  who.se  duty  it  is  to  make 
such  examinations  which  have  as  their  one  and  single  aim  the  determination  of 
the  cause  of  death  and  a  correct  and  analytically  interpretative  analysis  of  the 
surrounding  circumstances  attending,  must  be  a  physician  by  education,  tech- 
nically and  practically  trained  in  these  branches.  No  lay  or  professional  man 
other  than  a  well-trained  pathologist  as  above  defined  pos.ses.ses  the  requisite 
natural  or  legal  qualifications  to  discharge  properly  the  duties  of  such  an  office. 
4  ['s:i\ 


The  records  of  the  medical  examiner's  office  are  open  to  the  public,  and  daily 
use  of  such  records  is  made  by  representatives  of  insurance  companies,  the 
families  or  representatives  of  the  deceased,  the  army  and  navy  authorities 
(especially  during  the  late  war),  and  the  State  Industrial  Commission.  Whereas 
under  the  coroners,  the  chemical  examinations,  even  in  poison  cases,  were  not 
made  except  here  and  there,  when  the  services  of  the  pathological  chemist  of 
BelleYTje  Hospital  in  Manhattan  were  called  upon  to  aid  in  a  scientific  inquiry, 
the  office  at  the  present  time  is  constantly  required  to  furnish  evidence  of  the 
presence  or  absence  of  alcohol  and  of  poisons.  We  are  furnishing  constantly  to 
the  department  of  health,  the  census  bureau  at  Washington,  and  the  various 
insurance  companies,  information  in  order  to  give  them  accurate  data  for  pur- 
poses of  classification,  etc.  The  educational  value  of  our  reports  is  illustrated  by 
the  curious  fact  that  the  office  is  now  criticized  in  those  instances  where  chemical 
examinations  are  not  made. 

Without  the  aid  of  a  properly  organized  chemical  laboratory  many  certifi- 
cates of  death  would  be  signed  improperly.  A  most  noteworthy  illustration  of 
this  point  is  the  fact  that  before  the  attention  of  the  country  was  called  to  the 
so-called  epidemics  of  wood  alcohol  poisoning,  this  office  had  become  aware  of 
the  iniquitous  sale  of  methylated  spirits  in  place  of  grain  alcohol  through  the 
routine  clieniical  examination  of  cases  which  had  come  to  autopsj'^  in  which  the 
pathological  lesions  were  indefinite. 

The  difficulty  in  abolishing  a  long  and  well-established  office,  as  was  the 
coroner's,  is  abundantly  illustrated  by  the  discussions  which  took  place  before 
the  senate  committee  on  city  affairs  in  1915.  The  arguments  presented  by  the 
representatives  of  the  coroner's  system  were  that  the  coroners'  physicians  had 
surveyed  a  very  large  number  of  cases,  that  they  were  competent  in  view  of  this 
fact,  that  the  establishment  of  a  medical  examiner's  office  would  entail  an 
extraordinary  expenditure  of  moneys — some  claiming  that  a  satisfactory  substi- 
tute of  the  system  could  not  be  maintained  under  less  than  half  a  million  dollars 
a  year.  As  a  mere  matter  of  fact,  the  medical  examiner's  office  was  created  with 
a  budget  of  about  S65,000  less  than  the  coroner's  budget  for  Greater  New  York. 
The  favorite  arguments  of  the  coroners  were  that  they  were  the  protectors  of 
the  rights  of  the  people,  that  the  new  system  was  instituted  purely  for  the  bene- 
fits of  the  medical  colleges  and  that  the  introduction  of  a  new  system  was  merely 
a  scheme  to  obtain  sufficient  autopsies  for  medical  purposes.  Glaringly  false 
statements  were  made  in  the  hearing. 

The  Medical  Examiner  Faces  Perplexing  Problems 
One  of  the  most  serious  tasks  that  the  medical  examiner  performs  is  the 
determination  of  criminal  negligence  in  accident  cases.  This  consists  in  the 
investigation  of  the  circumstances  surrounding  the  deaths  in  various  industrial 
accidents,  the  analysis  of  poisonous  fumes  in  manholes,  the  deaths  resulting 
from  careless  cyanide  disinfection,  either  in  rooms  or  in  the  holds  of  vessels, 
deaths  resulting  from  salvarsan  poisoning,  deaths  resulting  from  structural 

[34  1 


defects  in  wood  from  dry  rot  and  in  the  careless  construction  of  buildings  and 
other  structures  in  general.  In  fact,  the  policj'-  of  the  office  is  to  bring  out  all 
the  facts,  medical,  pathologic,  or  chemical,  and  to  present  all  such  evidence  in 
proper  fashion,  making  direct  and  trustworthy  inferences  and  at  the  same  time 
to  avoid  the  danger  of  looking  at  facts  through  the  spectacles  of  theory. 

The  numerous  cases  of  asphyxiation  by  illuminant  gas  which  this  office 
handles  yearly  present  a  subject  of  considerable  importance  to  the  common- 
wealth. The  duty  of  the  office  is  not  merely  to  give  a  correct  determination  of 
the  cause  of  death,  namely,  whether  accidental,  suicidal,  or  homicidal,  hut  to 
report  to  the  proper  authorities  any  negligence  or  carelessness  on  the  part  of 
the  landowner  or  tenant  in  connection  with  the  attachments  of  the  gas  tubing 
to  the  heating  and  illuminating  apparatus  or  structural  defects  causing  leakage 
of  coal  gas  from  water  heaters  or  furnaces.  There  have  been  a  number  of  acci- 
dental deaths  due  to  the  habit  of  a  few  of  the  keepers  of  boarding-houses  of 
turning  off  the  gas  at  stated  hours  and  again  turning  on  the  gas  in  the  early 
morning  hours  when  the  tenants  arc  still  asleep,  the  burners  being  turned  on. 
One  of  the  difficulties  we  have  experienced  is  that  there  is  no  single  department 
which  has  responsibility  to  whom  such  cases  can  be  referred  with  a  certainty 
they  will  receive  prompt  attention  and  action.  The  inadvisability  of  the  use  of 
rubber  tubing  for  gas  connections  was  called  to  the  attention  of  the  board  of 
aldermen  a  few  years  ago  and  it  is  expected  that  action  will  be  taken  to  prohibit 
its  use  in  connections  of  this  kind. 

I  wish  to  call  attention  to  the  necessity  of  performing  autopsies  upon  all 
suspected  cases,  namely,  all  those  cases  in  which  the  diagnosis  cannot  be  made 
beyond  reasonable  doubt.  Curious  illustrations  have  occurred  in  this  office  to 
indicate  how  important  a  matter  this  is  to  the  community.  For  instance,  we 
have  had  two  cases  within  the  past  several  months  of  supposed  criminal  abor- 
tions in  women  in  their  early  forties,  upon  whom  criminal  abortions  have  been 
performed,  and  who  at  autopsy  were  found  not  pregnant.  The  department 
examines  cases  rejected  by  the  department  of  health  and  death  certificates 
signed  by  apparently  reputable  physicians  have  disclosed  cases  of  acute  gastro- 
enteritis which  turned  out  to  be  peritonitis  following  criminal  abortion,  and  cases 
of  suicide  in  women  supposedly  pregnant  (one  case  up  to  the  seventh  month, 
in  an  elderly  married  woman),  autopsy  revealing  that  there  was  no  pregnancy, 
pregnancy  being  feared  due  to  the  appearance  of  the  menopause  and  poison 
being  taken  to  deliver  a  supposed  foetus. 

Recommendations 

1.  The  office  of  coroner  should  be  abolished. 

2.  A  law  similar  to  the  New  York  or  Massachusetts  law  creating  a 
medical  examiner  should  be  enacted. 

3.  The  medical  examiner  should  be  a  physician,  expert  in  pathology 
and  in  medico-legal  investigations. 

4.  The  Board  of  County  Commissioners  should  njipoint  from  a  (•i\il 

f  3o  1 


service  list  a  medical  examiner,  and  in  counties  having  more  than  100,000 
inhabitants  should  appoint  a  chief  medical  examiner. 

5.  The  chief  medical  examiner  should  have  the  power  to  appoint  and 
to  remove  such  deputies,  assistant  medical  examiners,  scientific  experts, 
officers,  and  employees  as  may  be  provided  for  by  law. 

G.  The  medical  examiner  or  his  deputy  or  assistant  should  take  charge 
of  the  body  of  any  person  who  has  died  from  criminal  violence,  or  by  a 
casualty,  or  by  suicide,  or  suddenly  when  in  apparent  health  or  when 
unattended  by  a  physician,  or  in  prison,  or  in  any  suspicious  or  unusual 
manner. 

7.  If,  in  the  opinion  of  the  medical  examiner,  an  autopsy  is  necessary, 
it  should  be  performed  by  the  medical  examiner  or  his  deputy  or  assis- 
tants. 

8.  The  medical  examiner  should  be  in  charge  of  the  morgue. 

9.  Suitable  laboratories,  autopsy  rooms,  record  rooms,  and  vaults, 
properly  equipped  for  the  performance  of  whatever  investigations  may 
be  required  in  the  course  of  the  medical  examiner's  work,  should  be  pro- 
vided at  the  morgue. 

10.  A  budget  should  be  drawn  up  for  the  office  of  medical  examiner 
each  year,  based  upon  the  total  amount  of  work  to  be  done  and  not  upon 
any  proportionate  relation  to  other  public  expenditures. 

Prosecution 

There  is  no  provision  for  special  medical  examination  in  connection 
with  prosecutions.  It  is  left  to  the  discretion  of  the  prosecutor  to  call  in 
physicians  or  other  specialists  to  serve  as  expert  witnesses.  This  is  in 
accordance  with  the  course  pursued  almost  everywhere,  and  probably  is 
satisfactory,  according  to  present  standards.  There  are  certain  individ- 
ual prosecutors  who  consult  and  who  may  even  be  advised  by  experts 
throughout  a  trial  without  placing  them  upon  the  witness-stand.  While 
this  is  a  little  more  progressive  than  the  general  practice,  it  has  the  dis- 
advantage of  being  partisan. 

Prosecutors,  in  common  with  others,  would  benefit  if  there  were  avail- 
able a  body  of  expert  opinion  which  could  be  invoked,  as  a  routine 
measure,  in  all  criminal  cases. 

Adjudication 

/.  Municipal  Court 
In  the  Muni('i]>al  Court  no  special  provision  is  made  for  expert 
mctlical  or  mental  examinations.    Cases  dealt  with  by  tliis  court  are  in 
the  main  minor  ones.    They  do  not  attract  attention,  and  are  passed 

[3GI 


through  the  court  in  a  more  or  less  routine  fashion,  on  the  genei'al 
assumption  that  a  delinquent  requires  punishment. 

That  the  Municipal  Court  should  constitute  a  process  of  weeding  out 
socially  incompetent  individuals  or  serious  delinquent  types  not  yet 
guilty  of  a  major  crime  is  not  comprehended.  In  a  community  in  which 
pubUc  opinion  on  this  subject  is  more  advanced  the  Municipal  Court  is 
regarded  as  the  most  important  clearing-house  and  sorting  station  for 
keeping  the  stream  of  civic  life  pure. 

2.  Common  Pleas  Court 
The  Common  Pleas  Court,  criminal  branch,  hears  cases  of  insanity 
under  certain  conditions.    There  are  three  ways  in  which  such  cases  come 
before  this  court: 

1.  According  to  Sec.  13577,  General  Code,  the  grand  jury  may,  if  it 
finds  the  accused  person  insane,  report  that  finding  to  the  Common  Pleas 
Court  instead  of  indicting  the  person.  The  court  then,  as  provided  by 
law,  impanels  a  jury  to  try  that  fact,  whether  or  not  the  person  is  insane. 
If  found  insane,  he  is  committed  to  Lima  State  Hospital  for  the  criminal 
insane.  The  Ihlenfeld  case  is  the  first  and  only  case  to  be  dealt  with 
according  to  the  provisions  of  this  section.  Judge  Baer,  who  tried  the 
case,  says  this  method  saves  time  and  money. 

2.  After  a  person  has  been  indicted,  and  before  sentence,  his  attorney 
may  present  to  the  court  a  certificate  from  a  reputable  physician  to  the 
effect  that  the  person  accused  is  insane,  whereupon  a  jury  is  impaneled  to 
decide  the  matter.  The  burden  of  proof  rests  on  the  defense.  If  three- 
fourths  of  the  jury  find  the  accused  insane,  he  is  committed  to  Lima  State 
Hospital.    (Sec.  13608  ff.) 

3.  The  defense  of  insanity  may  be  made  at  a  regular  trial.  If  the  per- 
son tried  upon  an  indictment  for  an  offense  is  acquitted  on  the  sole 
ground  that  he  was  insane,  he  is  committed  to  Lima  State  Hospital,  Sec. 
13679.  In  all  cases,  if  restored  to  reason,  he  may  be  prosecuted  for  the 
ofifense. 

These  seem  to  be  the  only  ways  in  which  such  cases  come  before  the 
Common  Pleas  Court.  The  number  of  such  cases  is  small.  During  1919 
there  were  but  seven  cases.  No  separate  or  special  records  are  kept; 
the  records  of  the  number  of  such  trials  and  disposition  of  cases  arc  found 
in  the  general  Common  Pleas  docket.  The  prosecution  can  oppose  the 
plea  of  insanity  and  call  in  doctors  or  other  specialists  as  witnesses. 
There  is  no  special  provi.sion  in  law  for  calling  in  experts  or  for  their  com- 
pensation in  such  cases.  Judge  Levine  and  Judge  Baer  are  of  the  opinion 
that  the  Common  Pleas  judge  can  order  examination  to  be  made  as  to  an 

(37) 


accused  person's  sanity.     No  specific  powers  of  that  nature  are  men- 
tioned in  statutes. 

In  Judge  Baer's  opinion  there  should  be  a  laboratory  to  investigate 
the  mental  condition  of  persons  indicted,  especially  in  the  case  of  recidi- 
vists. Such  work  he  considers  belongs  to  a  specialist  and  not  to  the 
judge,  who  cannot  detect  such  cases  when  they  appear  in  court. 

8.  Probate  Court 

There  are  no  medical  experts  specially  attached  to  the  Probate  Court 
to  act  in  lunacy  and  feeble-minded  cases.  The  law  requires  that  in  every 
case  of  feeble-mindedness,  epilepsy,  or  insanity  two  reputable  physicians 
shall  be  called  in  as  medical  witnesses.  Technically,  these  are  selected 
by  the  probate  judge  in  each  case,  and  serve  only  for  that  case.  As  a  mat- 
ter of  practice,  of  course,  physicians  appointed  to  this  commission  are 
almost  always  the  same;  but  this  is  purely  dependent  on  the  judge's 
choice  and  judgment.  The  medical  witnesses  are  paid  $5.00  for  each 
case  in  which  they  testify,  or,  in  other  words,  $5.00  for  each  certificate. 
At  present  the  two  physicians  appointed  by  the  judge  are  experts  in 
mental  diseases,  having  had  experience  in  State  hospitals. 

There  is  no  equipment  for  this  work ;  the  court  does  not  control  any 
offices  or  laboratories,  though  when  it  is  not  possible  to  arrive  at  a  deci- 
sion without  special  observation,  the  court  is  able,  as  a  rule,  to  send  the 
patient  for  examination  to  the  psychopathic  ward  of  the  city  hospital, 
which  is  the  so-called  Detention  Hospital. 

No  selection  of  cases  is  possible ;  the  examinations  are  made  in  those 
cases  which  are  brought  into  the  Probate  Court  on  a  complaint  of  in- 
sanity, epilepsy,  or  feeble-mindedness.  Every  complaint  made  is  ex- 
amined. The  original  papers  in  all  cases  are  kept  in  the  office  of  the 
court.  Certified  copies  are  sent  to  the  hospital  or  other  institution  to 
which  the  patient  is  sent  for  examination  and  observation  or  to  which  he 
is  committed.    Reports  of  work  are  also  made  to  the  Secretary  of  State. 

The  examiners  perform  their  work  wherever  necessary,  according  to 
the  requirements  of  the  case.  They  visit  patients  in  their  homes  and  in 
hospitals,  at  the  State  hospital,  in  jails,  or  wherever  else  they  may  be. 
The  recommendations  of  the  medical  examiners  are  nearly  always  carried 
out.  The  judge  acts  upon  the  medical  experts'  advice  also,  and  has  con- 
fidence in  the  examiners  whom  he  selects  because  they,  in  his  opinion,  are 
careful  and  conscientious  in  their  work.  Since  the  medical  examiners  are 
appointed  ijy  the  judge,  their  mutual  relations  are  very  close.  Appar- 
ently no  other  consideration  than  their  fitness  for  the  work  enters  into 
their  appointments. 

[38] 


This  system,  which  is  obviously  open  to  many  theoretical  objections, 
especially  the  opportunity  it  affords  for  political  and  other  considerations 
to  play  an  important  part,  is  safeguarded  by  the  fact  that  the  present 
probate  judge  is  above  allowing  such  factors  to  influence  his  judgment. 
The  medical  examiners  are  free  from  the  objection  of  being  interested  in 
the  State  hospitals,  especiallj'  since  the  law  requires  that  no  physician 
officially  connected  with  these  may  serve  as  examiner  for  the  Probate 
Court. 

In  regard  to  the  relation  of  medical  examiners  to  commitment  of  in- 
sane persons,  there  is  this  to  be  said :  The  law  which  authorized  the  pay- 
ment to  the  medical  examiner  of  a  fee  for  each  case  committed  obviously 
places  a  premium  on  committing  individuals;  it  would  seem  that  the 
interest  of  the  physician  was  to  commit  persons  rather  than  to  keep  them 
out  of  institutions.  Any  possible  tendency  in  this  direction  is  counter- 
acted, however,  by  the  equally  potent  restraint  of  laws  concerning  mal- 
practice and  other  legal  actions. 

Nevertheless,  the  recompensing  of  these  special  witnesses  is  a  bad 
practice.  Physicians  are  not  only  open  to  the  influence  above  mentioned, 
but  personal  considerations  enter  in  which  have  no  place  in  this  connec- 
tion, such  as  the  fact  that  these  fees,  which  are  paid  through  public  funds, 
are  in  the  nature  of  a  largesse  and  should,  therefore,  be  distributed  among 
as  large  a  number  of  physicians  as  possible.  In  the  eyes  of  the  more 
unscrupulous  it  will  appear  as  a  downright  "graft,"  which  may  be  con- 
nived at  only  if  every  one  gets  his  full  share.  In  Cleveland,  as  in  other 
cities  where  this  system  is  used,  the  work  is  done  with  little,  if  anj^  evi- 
dence of  bad  influences.  Nevertheless,  from  the  point  of  view  of  effi- 
ciency, and  above  all  that  of  educating  pubhc  opinion,  it  should  be 
changed. 

The  tendency  in  all  matters  pertaining  to  insanity,  at  least  since 
Charles  Reade  published  Hard  Cash,  has  been  to  remove  all  specific 
incentive  in  the  matter  of  commitments.  This  fact,  probably  more  than 
any  other,  has  resulted  in  the  respect  shown  for  the  State  hospital  and 
the  prejudice  in  favor  of  this  institution  as  compared  with  private  insti- 
tutions for  mental  cases. 

The  decision,  whether  a  person  should  be  segregated  to  a  certain  ex- 
tent and  deprived  of  his  liberty,  should  be  made  on  purely  objective  evi- 
dence, and  while  it  is  true  that  the  court  makes  the  final  decision  and 
examines  the  records,  it  is  nevertheless  upon  the  evidence  submitted  i)y 
the  medical  experts  that  such  a  decision  is  made  by  the  court.  If,  then, 
medical  examiners  are  swayed,  either  consciously  or  unconsciously,  by 
other  reasons  than  those  based  upon  purely  objective  evidence,  the  court, 

[39] 


even  if  ignorant  of  this,  cannot  act  in  an  unbiased  way.  The  result  is  that 
medical  examiners  should  be  paid  either  a  salary  or  a  fixed  fee  for  every 
examination  they  make,  regardless  of  whether  commitment  is  recom- 
mended or  not.  At  present  they  are  paid  for  the  certificate  issued  and 
not  for  the  examination  made. 

The  same  statements  which  apply  to  the  question  of  expert  witnesses 
in  general  apply  here.  There  may  be,  and  probably  should  be,  two  kinds 
of  experts  available  to  the  courts,  the  one  serving  as  a  public  official  on 
salary,  for  either  full  or  part  time,  the  other  physicians  who,  in  addition 
to  the  usual  medical  qualifications,  have  quaUfied  and  been  appointed  as 
experts.  When  a  court  or  other  pubhc  oflficial  or  a  private  individual  re- 
quires the  services  of  an  expert  other  than  the  officially  salaried  expert,  he 
may  select  one  from  this  qualified  list.  This  system  does  not  force  any 
expert  upon  either  courts  or  private  individuals,  nor  does  it  require  the 
poor  man  to  suffer  because  he  cannot  afford  the  expensive  specialist. 
Furthermore,  it  guarantees  that  the  pubhc  oflftcial  will  be  non-partisan 
and  that  the  privately  retained  expert  will  at  least  measure  up  to  the 
minimum  standard  requirements. 

There  is  another  phase  of  the  relationship  between  the  medical  and 
particularly  the  mental  expert  and  the  Probate  Court.  In  the  Probate 
Court  questions  of  property  rights,  guardianship,  and  conservatorship 
continually  arise.  While  the  question  of  mental  disease  or  mental  de- 
ficiency may  not  arise,  there  may,  nevertheless,  be  important  considera- 
tions in  which  the  expert  knowledge  of  the  qualified  psychiatrist  would 
be  of  considerable  value  to  the  court.  This  refers  particularly  to  that 
very  large  field  of  personality  factors  which  we  are  just  beginning  to 
study  scientifically.  Every  judge  of  the  Probate  Court  will  readily  rec- 
ognize what  is  referred  to  here,  and  probably  every  judge  who  has  served 
in  the  Probate  Court  has  made  use  of  his  experts  in  non-insane  and  non- 
feeble-minded  cases,  for  the  purpose  of  evaluating  the  personality  factors 
before  making  a  decision. 

This  important  work  requires  specialization  and,  furthermore,  cannot 
be  done  satisfactorily  unless  experts  making  the  examinations  are  em- 
ployed on  full  time;  that  is,  the  experts  cannot  be  expected  to  be  effi- 
cient if  they  are  called  in  only  occasionally  on  such  cases — they  must  be 
dealing  with  them  as  a  matter  of  daily  routine. 

In  the  last  year  560  cases  have  been  examined  by  medical  commis- 
sions for  the  Probate  Court  at  $10  a  case,  or  a  total  expenditure  of  S5,600 
for  medical  fees  alone.  This  does  not  include  the  sheriff  fees,  witness 
fees,  and  other  incidentals. 

I  40  1 


Recommendations 

1.  A  chief  psychiatrist  should  be  appointed  by  the  judge  of  the  Pro- 
bate Court  from  a  civil  service  list. 

2.  The  chief  psychiatrist  should  be  empowered  to  appoint  from  a 
civil  service  list  three  assistant  or  deputy  psychiatrists,  one  psychologist, 
and  one  assistant  psychologist. 

3.  Suitable  salaries  should  be  provided  to  attract  properly  qualified 
experts. 

4.  The  necessary  clerical  assistance  and  office  quarters  should  be  pro- 
vided in  the  new  court-house  office  building  or  county  jail. 

5.  The  chief  psychiatrist  should  examine  and  pass  upon  all  cases  com- 
ing from  the  Probate  Court,  the  Municipal  Court,  and  the  Court  of 
Common  Pleas,  in  which  the  question  of  sanity  or  insanity,  epilepsy,  or 
mental  deficiency  is  raised. 

6.  The  chief  psychiatrist  should  cause  to  be  examined,  physically  and 
mentally,  in  so  far  as  possible,  all  persons  coming  before  the  Municipal 
Court. 

7.  The  chief  psychiatrist  should  present  to  the  courts  in  writing  a 
statement  of  the  findings  and  opinion  of  the  psychiatrist  in  each  case 
examined. 

8.  In  cases  of  dispute  or  doubt  the  court  should  be  able  to  appoint  a 
special  psychiatrist  to  examine  a  case. 

9.  The  person  to  be  examined,  his  counsel,  relatives,  or  friends,  should 
be  permitted  to  be  represented  by  a  psychiatrist  who  should  have  access 
to  the  findings  of  the  chief  psychiatrist,  and  who  may  be  present  at  and 
participate  in  the  examination  by  the  chief  psychiatrist,  but  who  may 
not  interfere  with  the  conduct  of  such  examinations. 

10.  The  sheriff  of  Cuyahoga  County  and  the  Director  of  Public  Welfare 
should  be  able  to  call  upon  the  psychiatrist  to  examine  any  person  in  their 
custody  and  to  enter  a  petition  for  commitment  of  any  person  thus  ex- 
amined who  shall  be  found  to  be  insane,  epileptic,  or  feeble-minded. 

11.  Whenever,  in  the  opinion  of  the  psychiatrist,  any  person  exam- 
ined requires  more  extended  study  or  observation  than  can  be  given  at 
the  county  or  city  jail,  application  should  be  made  to  the  court  having 
jurisdiction,  for  temporary  care  at  the  city  psychopathic  hospital  for  a 
period  of  ten  days,  or  not  more  than  three  months,  or  until  such  time  as 
the  director  of  the  psychopathic  hospital  shall  depose  in  writing  that  the 
examination  or  observation  has  been  completed. 


(41 


CHAPTER  IV 
PREVENTION 

Early  Detection  of  Special  Cases 

IF  WE  may  correctly  assume  that  delinquencj''  in  most  instances  is 
not  merely  accidental,  but  is  associated  with  characteristics  and  per- 
sonal peculiarities  inherent  in  the  individual,  it  must  follow  that 
any  attempt  at  prevention  must  include  elimination  at  the  source.  By 
this  we  mean  the  examination  of  children  of  school  age  and  even  younger 
from  the  point  of  view  of  mental  and  personality  characteristics,  as  mani- 
fested especially  in  behavior.  It  is  by  no  means  a  certain  or  a  simple 
matter  to  determine,  even  after  careful  examination,  which  children  will 
present  major  behavior  problems  later  in  life.  But  it  is  certainly  possible 
to  determine  which  ones  are  in  need  of  immediate  special  training  and 
which  show  present  behavior  or  mental  deviations. 

A  careful  study  of  this  kind,  followed  by  intensive  training  and  obser- 
vation of  the  physical,  mental,  and  social  factors  involved,  will,  if  applied 
to  enough  children,  be  comparable  to  the  results  obtained  in  the  same 
circumstances  by  the  methods  of  physical  health  training.  If  these 
methods  now  succeed  in  the  Juvenile  Courts,  where  they  are  applied 
after  delinquency  develops,  there  is  every  reason  to  expect  even  more 
satisfactory  results  when  applied  earlier,  before  the  major  problems  of 
delinquency  appear.  When  such  a  plan  has  been  in  operation  for  a  gen- 
eration, it  is  not  unUkely  that  the  problem  of  delinquency  in  the  com- 
munity will  have  changed  so  much  as  to  make  jails,  as  we  now  know 
them,  quite  unnecessary.  We  shall  probably  always  require  places  of 
detention,  but  with  a  better  understanding  of  the  real  causes  of  delin- 
quency and  crime  and  with  more  effective  methods  of  prevention  and  treat- 
ment it  is  fair  to  assume  that  future  detention  institutions  will  differ  from 
the  present  ones  as  modern  hospitals  differ  from  the  ancient  pest  houses. 

Meanwhile  the  police  will  continue  to  pick  up  and  detain  a  large  num- 
ber of  individuals  who  are  a  source  of  trouble  and  loss  to  the  community 
and  of  little  profit  to  themselves.  Even  in  these  cases  an  inteUigent  atti- 
tude requires  that  suitable  studies  shall  be  made  of  each  individual  case 
in  order  really  to  solve  the  problem,  instead  of  depending  entirely  on 
forcible  detention  and  segregation  and  the  supposedly  curative  effects  of 

[42] 


punitive  imprisonment.     The  number  of  recidivists  who  pass  through 
our  jails  is  ample  evidence  against  such  misplaced  confidence. 

Even  if  a  thorough  examination  of  each  prisoner  is  not  possible,  a 
sorting  by  simple  examinations  will  identify  extreme  typos  of  feeble- 
minded or  psychopathic  individuals.  Individuals  who  are  brought  to 
light  b}^  these  sorting  examinations  cannot  ho  properly  disposed  of  with- 
out treatment,  and  the  treatment  which  may  be  given  is  one  of  three 
general  types  or  combinations  of  these,  namely,  physical,  mental,  or  social. 

Phj'sical  treatment  is  directed  against  physical  disease,  on  the  one 
hand,  and  physical  handicaps  and  defects,  on  the  other.  It  is  not  nec- 
essary to  enlarge  upon  this  familiar  topic.  The  main  thing  to  emphasize 
here  is  the  unportance  of  correcting  all  physical  disabilities,  even  those  of 
apparently  minor  significance,  in  the  interest  of  improving  the  mental 
and  behavior  reactions.  Physicians  often  err  in  minimizing  the  effects  of 
minor  phj'sical  ailments. 

For  example,  in  the  field  of  the  psychoneuroses,  as  exemplified  by  the 
cases  of  so-called  shell-shock  during  the  war,  the  slighter  the  physical 
injury,  the  greater  the  psychic  disturbance.  In  the  field  of  behavior  diffi- 
culties this  is  often  markedly  true.  It  is  obvious,  therefore,  that  physical 
examination  must  be  performed  with  subtlety  and  niceness  of  observa- 
tion. Clearly  a  physician,  to  be  effective  in  the  physical  examination  of 
behavior  cases,  must  approach  his  work  from  a  dififerent  angle  from  his 
general  medical  practice.  The  examination  thus  performed  must  then  be 
correlated  with  the  mental  and  social  factors  of  each  case  in  order  that 
suitable  physical  treatment  may  be  prescribed. 

Mental  treatment  consists  in  the  main  of  two  kinds:  first,  education 
and  training  of  various  mental  faculties  or  talents,  which  are  carried  out  in 
accordance  with  estabhshed  principles  of  educational  training  and  certain 
sorts  of  habit  formation;  second,  treatment  by  various  means  of  what 
may  be  considered  pathological  mental  traits.  Psychotherapy,  hydro- 
therapy, mechanotherapy,  occupational  therapy,  and  other  modern 
forms  of  treatment  may  be  applied  by  trained  experts  to  good  effect. 

Social  treatment  is  perhaps  the  most  modern  and  least  well  defined  of 
all  the  various  forms  of  treatment.  As  applied  to  delinquency,  it  consists 
mainly  of  adjusting  environmental  conditions  to  the  needs  of  the  individ- 
ual case.  The  important  point  is  not  merely  to  change  the  environment, 
but  to  adapt  the  environment  to  the  needs,  temporary  or  j)ermanent,  of 
an  individual  more  or  less  incapable  of  adapting  himself.  This  form  of 
treatment  is  consequently  varied,  and  includes  the  adjustment  of  the  in- 
dividual to, living  conditions  in  his  particular  community,  as  well  as  social 
relief,  recreation,  or  employment. 

[43  1 


Public  Information  and  Education 

One  of  the  most  potent  influences  in  prevention  is,  of  course,  public 
education.  As  in  public  health,  the  only  effective  way  to  educate  the 
public  is  by  spreading  broadcast  the  knowledge  now  available  to  which 
the  pubHc  is  entitled. 

Unfortunately,  in  this  era  of  advertising,  everyone  is  becoming  suspi- 
cious of  propaganda  conducted  under  the  guise  of  public  education.  It  is, 
therefore,  necessary  to  force  upon  the  public  something  more  than  off- 
hand opinions  and  prejudices.  Ultimate  progress  depends  upon  the 
strict  adherence  to  facts.  For  example,  during  recent  years  considerable 
propaganda  has  been  adopted  to  prove  that  feeble-mindedness  is  one  of 
the  principal  causes  of  criminality.  It  has  been  contended  that  if  we 
detect  and  segregate  the  feeble-minded  early  in  life,  we  can  reduce  crime 
by  one-third  to  one-half,  if  not  more.  This  belief  was  based  upon  the 
finding  that  in  certain  institutions  from  one-fourth  to  one-third  of  the 
institutional  population  was  rated  feeble-minded  by  intelligence  tests. 

This  contention  was  given  a  most  favorable  reception,  and  for  a  time 
promised  to  induce  a  more  scientific  attitude  on  the  part  of  officials  to- 
ward the  various  phenomena  of  crime,  and  also  to  arouse  a  greater  inter- 
est in  and  support  of  the  institutional  care  of  the  feeble-minded.  Certain 
officials — police,  prosecutors,  attorneys,  prison  authorities,  in  short,  all 
who  were  brought  in  close  contact  with  the  criminal  population — were 
reluctant  to  accept  these  statements,  but  their  attitude  was  ascribed  to 
natural  conservatism. 

More  recent  work  has  shown  that  while  figures  for  the  institutions 
were  undoubtedly  correct,  the  interpretation  placed  upon  them  was  not 
correct,  because  it  failed  to  take  into  account  the  nature  of  the  population 
from  which  the  prisoners  came.  From  information  now  available  in  re- 
gard to  the  intelligence  distribution  throughout  the  United  States  it 
appears  that  the  prison  populations  are  probably  fairly  representative,  so 
far  as  intelligence  goes,  of  the  communities  from  which  they  come.  It 
may  be  true,  therefore,  that  a  quarter  of  the  persons  in  a  given  institution 
are  feeble-minded,  but,  in  order  to  reduce  crime  by  25  per  cent,  not  only 
would  25  per  cent,  of  the  prison  population  have  to  be  committed  to  an 
institution  for  the  feeble-minded,  but  25  per  cent,  of  the  population 
from  which  they  came  would  have  to  be  segregated,  which  is  clearly 
ridiculous. 

This  illustrates  one  of  the  dangers  of  the  proposed  methods,  even 
when  applied  to  a  worthy  purpose.  Nothing  could  be  more  desirable 
than  the  scientific  treatment  of  criminals  and  the  application  of  psycho- 
logical, psychiatric,  and  other  mental  methods  to  criminals  and  delin- 

[44] 


quents.  But  it  is  a  mistake  to  make  the  success  of  such  a  venture  depend 
upon  arousing  the  pubUc's  interest  by  unwarranted  statements.  In  the 
business  world,  where  an  effect  is  desired  for  a  short  time,  such  methods 
may  be  legitimate,  but  in  the  case  of  treatment  of  crime,  where  we  are 
building  for  generations  ahead,  they  are  nothing  short  of  dangerous.  The 
psychology-  of  salesmanship  has  no  place  in  the  sphere  of  science.  The 
reaction  in  the  public  mind  of  arousing  interest  on  the  basis  of  statements 
which  are  only  partly  true  causes  a  loss  of  confidence  which  retards  prog- 
ress more  than  initial  conservatism. 

Research 

WTicre  shall  the  facts  and  information  be  obtained  upon  which  a 
campaign  of  pubhc  education  may  be  based? 

Obviously,  in  an  experimental  subject,  such  as  criminology',  and  one 
in  which  science  is  just  beginning  to  make  itself  felt,  concrete  information 
is  extremely  scanty.  In  order  to  keep  pace  with  the  progressive  demands 
of  modern  community  life  and  the  growing  pubhc  interest,  provision 
must  be  made  for  investigation  and  research  into  the  nature  and  treat- 
ment of  delinquency  and  crime. 

Such  scientific  research  requires  the  same  arrangements  as  any  other 
sort  of  scientific  investigation.  In  the  first  place,  there  must  be  properly 
trained  and  equipped  experts.  They  must  have  a  place  in  which  to  work 
which  is  officially  designated  the  laboratory,  and  in  which  are  provided  all 
the  necessary  paraphernaUa  for  scientific  research.  This  is  not  the  place 
to  enter  into  detailed  statements  as  to  the  exact  size  or  arrangement  of 
such  laboratories  or  staff.  These  depend  largely  upon  the  resources 
which  the  community  makes  available  for  the  purpose  and  the  interest 
which  it  arouses. 

Since  scientific  research  is  at  best  an  uncertain  matter,  a  hberal  allow- 
ance or  margin  of  safety  is  advisable  in  order  to  insure  a  minimum  of  re- 
turn. There  are  no  rules  for  this  work,  and  there  is,  as  yet.  no  standard. 
It  would  be  better,  however,  for  Cleveland  not  to  venture  into  this  field  at 
all  unless  the  start  can  be  made  on  a  scale  commensurate  not  only  with 
the  size  and  importance  of  the  city,  but  with  the  size  and  menace  of  the 
problem. 

A  research  laboratory  or  institution,  properly  staffed  and  equipped, 
could  conduct  .scientific  investigations  into  behavior  problems  for  the 
police,  schools,  pubhc  health  bureaus,  courts,  jails,  correctional  and  penal 
institutions,  and  the  numerous  public  and  private  social  agencies. 

In  another  part  of  this  section  of  the  survey  there  is  a  brief  account 
of  a  psychological  analysis  of  the  population  of  the  Cleveland  workhou.se. 

[45  1 


It  will  be  seen  from  this  analysis  that  the  workhouse  has  a  large  number 
of  low-grade  feeble-minded  men.  Reference  to  the  chart  will  show  that 
the  number  is  out  of  proportion  to  the  rest  of  the  community.  Clearly, 
here  is  a  problem  for  mental  science — for  the  student  of  the  pathology  of 
human  behavior.  We  are  spending  several  hundred  million  dollars  in  the 
United  States  annually  in  dealing  with  the  end  results  of  criminality  and 
behavior  disorders.  Probably  not  S500,000  is  being  spent  in  a  scientific 
attack  upon  the  causes} 

Training  of  Workers  and  Experts 

The  plan  outlined  thus  far  has  discussed :  (a)  The  workers  for  prac- 
tical daily  routine;  (b)  the  research  institution  and  staff,  where  new 
knowledge  may  be  sought  and  gained ;  and  (c)  the  dissemination  of  in- 
formation to  train  and  direct  public  opinion.  There  is  left  one  more  item 
to  round  out  the  scheme,  and  that  is  a  provision  for  the  training  of  work- 
ers and  experts  who  are  to  take  their  places  in  the  ranks. 

Whenever  a  community  has  been  aroused  on  the  subject  of  mental 
problems,  and  particularly  behavior  problems,  and  has  finally  decided 
to  establish  scientific  work,  the  perplexing  question  presents  itself: 
"Where  shall  we  find  the  workers?"  It  must  be  admitted  that  the 
workers  available  for  immediate  employment  in  this  field  are  limited  in 
number.  This  is,  however,  not  to  be  wondered  at,  nor  is  it  an  indication 
that  the  subject  does  not  appeal  to  scientific  minds. 

Rather  it  is  a  manifestation  of  one  of  the  many  vicious  circles  in  our 
social  organization.  There  must  be  a  demand  for  this  work  and  a  realiza- 
tion on  the  part  of  the  public  of  its  importance  great  enough  to  insure  a 
career  for  the  workers.  This,  in  turn,  depends  upon  the  attainment  of 
results  of  a  concrete  and  practical  sort,  to  stimulate  public  interest. 
Many  who  might  have  been  glad  to  devote  their  lives  to  this  science  have 
been  compelled  to  seek  other  fields  by  a  failure  to  obtain  either  oppor- 
tunity or  remuneration  enough. 

In  order  permanently  to  break  up  this  vicious  circle  and  to  make  the 
scheme  outlined  here  quite  clear,  we  must,  therefore,  add  a  provision  for 
the  training  of  workers  and  experts.    This  training  should  be  given  in  the 

'  It  is  as  well,  perhaps,  to  state  here  that  the  term  "scientific,"  as  used  repeatedly 
in  this  report,  is  not  vised  as  applied  to  the  worker  in  the  exact  sciences.  The  scientist 
referred  to  here  is  not  a  man  manii)ulatiiip;  test-tubes  and  galvanometers  alone.  The 
investigation  of  behavior  problems  requires  scientists  equipped  to  deal  not  only  with 
the  methods  of  exact  science,  but  also  those  who  are  capable  of  devoting  themselves 
to  problems  of  education  and  social  organization. 

1461 


main  under  the  auspices  of  a  research  laboratory,  as  we  suggested,  and  in 
connection  with  the  schools  and  universities  of  the  community.  Such 
training  should  be  offered,  in  the  first  place,  to  physicians,  lawyers,  psy- 
chologists, psychiatrists,  social  workers,  administrators,  and  public  offi- 
cials. A  flexible  curriculum  should  permit  these  different  classes  of  pro- 
fessional workers  to  obtain  the  training  needed  to  make  their  particular 
contact  with  the  problem  of  delinquency.  In  order  to  do  this  it  might  be 
desirable  to  utilize  existing  departments  of  the  university,  perhaps  the 
medical  school.  The  latter  is  preferable  to  the  law  school,  but  close 
correlation  between  the  law  school  and  such  work  in  the  medical  school  is 
essential. 

In  addition,  special  courses  should  be  offered  to  social  workers,  parole 
and  probation  officers,  police  officers,  teachers,  and  nurses.  Here  again 
the  curriculum  might  be  so  arranged  that  police  officers,  for  instance, 
should  receive  a  brief  and  intensive  training,  whereas  social  workers  and 
probation  officers  should  receive  a  more  extended  training.  A  scheme 
such  as  this,  furthermore,  makes  possible  part  time  graduate  work  or 
special  investigations,  just  as  now  a  properly  qualified  student  may  enter 
a  laboratory  for  post-graduate  study  on  a  special  topic. 

When  an  organization  of  this  sort  has  functioned  long  enough  to  pro- 
duce the  first  graduates,  the  community  can  equip  itself  in  such  a  way  as 
undoubtedly  to  reap  the  benefit  in  a  continually  lessened  cost  of  adminis- 
tration of  criminal  justice;  and  not  the  least  of  the  benefits  to  be  ex- 
pected from  such  an  organization  is  that  other  communities,  no  less 
anxious  to  improve  their  crime  statistics  than  Cleveland,  and  no  better 
off  for  staff  or  special  workers,  will  turn  to  Cleveland  for  their  personnel. 

Recommendations 

1 .  If  possible,  a  privately  supported  institute  or  clinic  should  be  estab- 
lished either  independently  or,  preferably,  in  connection  with  Western 
Reserve  University. 

2.  The  object  of  the  institute  should  be: 

(a)  Investigation  of  the  nature  and  treatment  of  human  behavior 
difficulties. 

(b)  The  training  and  education  of  special  workers  and  experts  in  the 
field  of  behavior  problems. 

3.  The  institute  should  have  a  staff  comprehensive  enough  to  include 
the  methods  of  physical  and  mental  health  and  the  social  sciences. 

4.  The  institute  shall  be  equipped  with  the  necessary  laboratory 
space  and  apparatus  and  with  bed  capacity  for  a  limited  number  of 
patients. 

[47] 


APPENDICES 


APPENDIX  I 

REPORT  OF  INTELLIGENCE  SURVEY  OF  THE  CLEVELAND 
POLICE  DEPARTMENT 

By  E.  K.  Wickman 

Psychologist,  Division  of  the  Criminologist,  Illinois 

A  SURVEY  of  the  intelligence  of  the  personnel  of  the  Division  of 
Police  of  Cleveland  was  made  in  connection  with  the  survey  of  the 
^  administration  of  justice  conducted  by  the  Cleveland  Foundation. 
Mental  ratings  on  979  officers,  detectives,  and  patrolmen  were  secured 
by  the  use  of  the  army  Alpha  Intelligence  Examination. 

The  survey  was  made  with  the  cooperation  of  the  Chief  of  PoUce, 
Frank  W.  Smith,  who  ordered  the  men  of  his  department  assembled  for 
the  examination  and  who  lent  his  cooperation  and  influence  to  their  effec- 
tive administration  and  completion.  The  examinations  were  not  com- 
pulsory for  the  men,  with  the  exception  of  those  in  the  training  school. 
Orders  by  the  Chief  of  Police  were  issued  for  all  men  who  were  on  active 
duty  during  the  three  days  of  the  survey  to  report  for  the  examination, 
but  the  actual  examination  was  taken  voluntarily.  There  were,  however, 
no  men  in  the  department  who  declined  to  submit  to  the  tests. 

The  979  men  who  were  examined  compose  over  90  per  cent,  of  the 
entire  department,  and  the  men  who  were  not  rated  were  not  actually 
available  for  the  examination  during  the  three  days  of  the  survey.  The 
general  orders  for  the  assembling  of  the  men  called  for  one-half  of  one 
of  the  four  platoons  for  each  group  examination.  The  examinations  were 
made  on  the  salary  time  of  the  men,  and  the  groups  were  assembled  at  1, 
2,  and  3  o'clock  in  the  afternoons,  and  at  7.30  and  10  o'clock  in  the 
evenings.  The  979  men  include  officers  (captains,  lieutenants,  and  ser- 
geants), detectives,  men  of  the  vice  bureau,  the  traffic,  mounted,  emer- 
gency, and  regular  patrolmen,  and  the  members  of  the  training  school. 

The  intelligence  examination  used  was  the  army  Alpha  examination, 
the  scale  employed  for  Hterates  in  the  examination  of  officers  and  recruits 
in  the  United  States  army.  The  army  procedure  in  the  administration 
of  the  examination  was  adhered  to  in  all  respects.  The  groups  varied  in 
size  from  10  to  90  men.    With  the  exception  of  the  captains  and  detec- 

[48] 


tives,  the  groups  were  assembled  in  the  training  school  class 
Eighth  Precinct  Police  Station.  All  five  forms  of  the  Alpha 
were  employed,  so  as  to  avoid  possible^  coaching. 

The  papers  were  later  scored  by  special  clerks,  and  in(( 
ings  were  assigned  to  all  the  men  on  the  basis  of  the  army 
scale,  as  follows: 


Grade  of 
intelligence  Explanation 

A  Verj-  superior  intelligence 

B  Superior  intelligenee 

0+  High  average  intelligence 

C  Average  intelligence 

C —  Low  average  intelligence 

D  Inferior  intelligence 

E  Verj'  inferior  intelligence 


Alpha  score 

13.5-212 

105-134 

75-104 

4.5-  74 

25-  44 

15-  24 

0-  14 


-room  of  the 
examination 

•Uigence  rat- 
letter  rating 

Approximate 

mental  age, 

years 


11-13 
9-10.9 
Below  9 


The  distribution  of  intelligence  ratings  for  the  officers,  detectives,  and 
various  divisions  of  the  patrolmen  is  shown  in  Tables  1  and  2  and 
Diagram  1. 


PER  CENT  LOW  AVERAGE 
AND  INFERIOR 


PER  CENT 
AVERAGE 


PER  CENT.  HIGH 
AVERAGE 


pro  CENT.  SUPERIOR 


r 

28.6 

28.6 

n 

Capt 

lirs 

2.2I 

1     21.7 

39.1 

1 

Lieute 

lanta 

E 

he. 3 

28.2 

1 

Serge 

ints 

3.2  I       20.6 

1 

47.5 

23.6 

1 

Detoc 

tlvee 

] 

5.0  ta        20.0 

1 

41.3 

22.5 

ric 

2.6||xcyt 

cz 

34.2 

34.2 

1 

Uoun 

bed 

4.o||[ex 

1 

44.0 

24.0 

1 

Emerg 

incy 

(^ 

1 

56.4 

23.1 

1 

Training 

school 

4.9B        20.3 

L 

33.6 

29.1 

_j 

11.2 


^^^^^     11.9 
Patroliten 

Diagram  1. — Intelligence  ratings  of  divisictns  of  Cleveland  police  department 


About  40  per  cent,  of  the  officers  of  the  department  rate  in  the  su- 
perior grades  of  intelligence.    These  ratings  were  secured  by  about  13.5 
per  cent,  of  the  draft  army.    Another  32  per  cent,  of  the  officers  are  of 
high  average  intelligence;   about  20  per  cent.  ar(>  average^  while  (>  per 
5  149] 


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s 

.—1 

6 1— ( ic  "tf  T}<     •    • 
Z                      ... 

-^ 

+       1 

50] 


cent,  are  low  average.    There  are  no  representatives  among  the  officers 
in  the  inferior  grades  of  inteUigence. 


TABLE 

2.— SUMMARY  OF  DISTRIBUTION  OF  INTELLIGENCE  RATINGS 

All 

Vice 

Detec- 

All 

Total 

Draft 

officers 

Bureau 

tives 

patrolmen 

army 

Per 

Per 

Per 

Per 

Per 

No. 

cent. 

No. 

cent. 

No. 

cent. 

No. 

cent. 

No. 

cent. 

Per  cent. 

A 

12 

9.2 

4 

15.4 

21 

2.8 

37 

3.S 

4.5 

B 

42 

32.0 

9 

34.6 

3 

4.8 

73 

9.6 

127 

13.0 

9.0 

c+ 

42 

32.0 

8 

30.8 

15 

23.8 

214 

28.2 

279 

28.5 

16.5 

c 

27 

20.6 

4 

15.4 

30 

47.6 

274 

36.1 

335 

34.2 

25.0 

c- 

8 

6.1 

1 

3.8 

13 

20.6 

143 

18.8 

165 

16.9 

20.0 

D 

2 

3.2 

27 

3.6 

29 

2.9 

15.0 

E 

7 

0.9 

7 

0.7 

10.0 

131 

100.0 

26 

100.0 

63 

100.0 

759 

100.0 

979 

100.0 

100.0 

Of  the  patrolmen,  there  are  12  per  cent,  in  the  superior  grades,  28  per 
cent,  are  high  average,  while  the  greatest  percentage  (34)  are  average. 
There  is  a  heavier  percentage  of  patrolmen  in  the  low  average  group  than 
in  the  superior  groups,  and  about  3  per  cent,  are  definitely  in  the  inferior 
grades  of  intelligence.  Of  the  various  divisions  of  the  patrolmen,  the 
emergency  and  mounted  police  have  the  higher  intelligence  distributions. 

The  detectives,  a  group  of  63  men,  rate  lowest  in  the  entire  depart- 
ment. There  are  less  than  5  per  cent,  in  the  superior  grades,  and  about 
23  per  cent,  are  high  average,  while  70  per  cent,  are  either  average,  low 
average,  or  inferior. 

A  further  comparison  of  these  divisions  of  police  is  shown  in  Table  3 
and  in  Diagrams  2  and  3,  by  comparing  their  median  scores  and  the 
range  of  scores  of  the  high,  middle,  and  low  third  of  each  division.  The 
median  scores  of  the  officers  varies  between  95  and  98.  These  are  high 
scores  in  the  high  average  grade  of  intelligence.  The  patrolmen  have  a 
median  of  67,  which  falls  in  the  average  grade  of  intelligence,  while  the 
detectives  are  the  lowest  of  the  divisions,  with  a  median  of  59. 

At  present  the  detectives  are  ranking,  as  far  as  salary  is  concerned, 
with  the  lieutenants,  but  a  comparison  of  these  two  groups  shows  that 
the  lieutenants  have  37  per  cent,  of  representatives  in  the  superior  grades 
of  intelligence,  as  opposed  to  4.8  per  cent,  of  the  detectives,  and  only 
23.9  per  cent,  in  the  average  and  low  average  grades,  as  compared  with 
71.4  per  cent,  of  the  detectives.  The  lieutenants'  metlian  falls  at  95, 
while  the  detectives'  is  59.  Furthermore,  the  low  third  of  the  lieutenants 
has  a  higher  range  of  scores  than  the  middle  third  of  the  detectives. 

[511 


TABLE  3— MEDIAN  SCORES  AND  RANGE  OF  SCORES  OF  POLICE 

DIVISIONS 


Range  of  scores  of  each  division 

Rank  or  division 

Median 

Low  third 

Middle  third 

High  third 

Captains 

98  C  + 

50-75 

76-104 

105-154 

Lieutenants 

95  C  + 

36-81 

82-108 

109-165 

Sergeants 

99  C+ 

28-79 

79-109 

110-166 

Vice  squad 

7oC=F 

23-61 

64-  84 

84-134 

Detectives 

59  C 

23-50 

51-  71 

72-131 

Training  school 

63  C 

25-56 

57-  74 

77-138 

Traffic 

61  C 

5-56 

56-  74 

75-137 

Mounted 

78  C+ 

22-59 

60-  91 

92-155 

f^mergency 

67  C 

19-64 

65-  80 

83-150 

Patrolmen 

67  C 

6-52 

53-  82 

82-170 

When  compared  with  the  results  obtained  from  the  recent  draft 
army,  there  is,  of  course,  a  very  small  percentage  (3.6  per  cent.)  of  men 
in  the  police  department  who  rate  in  the  inferior  grades  of  intelligence 
in  which  the  lowest  25  per  cent,  of  the  men  in  the  draft  army  were  classi- 
fied. The  men  of  the  police  department  group  themselves  closely  about 
the  average  grade  of  intelligence,  and  the  medians  of  the  patrolmen  are 
about  identical  with  the  medians  of  the  draft  army.  With  the  exception 
of  the  officers,  there  is  a  smaller  percentage  of  representatives  in  the 
police  department  in  the  superior  grades  of  intelligence  than  were  found 
in  the  draft  army.  The  detectives  have  no  representatives  in  the  very 
superior  grade  of  intelligence,  a  classification  secured  by  4.5  per  cent,  of 
the  draft  army,  and  only  three  individuals  of  the  detectives  have  superior 
intelligence,  as  opposed  to  9  per  cent,  of  the  draft.  As  a  whole,  however, 
the  police  department  ranks  somewhat  higher  than  the  majority  of  the 
men  of  the  draft.  This  is  evident  in  its  somewhat  larger  percentage  of 
representatives  of  high  average  intelligence. 

Table  4  shows  a  distribution  of  intelligence  ratings  of  patrolmen  ac- 
cording to  the  date  of  entry  into  the  police  department.  There  is  very 
little  difference  in  the  ratings  of  the  first  year  groups,  who  entered  be- 
tween 1895-1919.  There  is  a  sUght  decrease  with  length  of  service,  much 
of  which  may  be  attributed  to  the  deterioration  of  increasing  age.  The 
table  also  shows  that  the  men  who  entered  during  the  present  year,  1921, 
have  a  considerably  higher  percentage  of  men  of  superior  intelligence. 
The  war  year,  1918,  produced  no  men  either  of  superior  or  of  inferior 
intelligence.  All  of  the  entrants  in  that  year  rate  in  the  average  classes 
of  intelligence. 

[  52  1 


I Captains  | 


Lieutenants 


Sergeants  | 

Detectives  I  59 


S8 
95 
99 


Vice  squad  I 


75 


Traffic  police  I  ^-^ 

Mounted  police  I  78 


Emergency  police  I  67 


Patrolmen I  67 
Training  school  I  63 


40 


Diagram  2. — Median  scores,  Cleveland  police  department 


ALPHA  SCORE 
D  50  60  70  80  90  100  110  12C 

'    ■    I    ■ I I I I    I    ■ I I [ I L-i I 


Sergeants 


Lieutenantf 


Captaine 


Emergency 


Mounted 


Training  school 


Vice  squad 


3 


P&trolben 


IVtectiveB 


Traffic  police 

Diagram  3. — Range  of  scores  between  first  and  third  quartiles  of  Cleveland  police 
department.     (The  median  scores  are  indicated  by  the  cross  lines.) 

153  1 


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police 
dept. 

S  B  fo  ^3  X  t'  o  c^i  c 

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g   00 

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d 

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1895- 
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1905- 
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1910- 
1914 

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Entered 
1915- 
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54 


APPENDIX  II 
INTELLIGENCE  SURVEY  OF  THE  CLEVELAND  WORKHOUSE 

By  E.  K.  WicKMAN 

Psychologist,  Division  of  the  Criminologist,  Illinois 

AN  INTELLIGENCE  survey  of  the  workhouse  of  Cleveland,  Ohio, 
/-\  was  made  in  connection  with  the  survey  of  the  Administration  of 
"^  -^  Justice,  to  illustrate  some  of  the  results  which  may  be  obtained 
by  mental  studies.  The  population  of  this  institution  was  about  450  men, 
of  whom  about  one-fifth  were  examined  by  the  use  of  the  Army  Alpha 
Intelligence  Examination.  This  one-fifth  was  chosen  bj^  assembling  the 
men  in  single  file  and  selecting  every  fifth  man  in  line  for  examination. 
To  this  group  were  added  all  of  the  men  who  were  at  the  workhouse  on 
federal  charges,  and  also  the  group  of  men  called  "long  termers."  One 
hundred  and  twenty-six  men  were  thus  assembled  for  the  examination; 
of  these,  32  were  illiterate  and  were  unable  to  take  the  examination,  inso- 
far as  they  claimed  to  be  unable  to  read  and  write,  and  one  other  man 
was  unable  to  take  the  examination  because  of  poor  vision. 

Records  were  thus  secured  on  93  of  the  men,  of  whom  44  (47  per  cent.) 
were  native-born  whites,  32  (34  per  cent.)  were  negroes,  and  13  (14  per 
cent.)  were  foreign  born.    Four  men  did  not  indicate  bii'th  or  race. 

The  distribution  of  intelligence  ratings  as  secured  by  the  army  Alpha 
examination  is  given  in  Table  5. 

The  literate  native-born  white  group  who  took  the  examination  fall 
mostly  in  the  average  grades  of  intelligence,  but  about  15  per  cent,  of 
them  are  inferior.  The  army  statistics  show  about  14  per  cent,  inferior  in 
this  group  of  native-born  whites.  There  are,  however,  only  about  4  per 
cent,  in  the  superior  groups,  as  opposed  to  15  per  cent,  in  the  army. 

Of  the  negroes,  61  per  cent,  fall  in  the  inferior  groups  of  intelhgencc  as 
opposed  to  43  per  cent,  in  the  army. 

The  average  rating  for  the  white  prisoners  fall  in  the  "C"  or  average 
group  of  intelligence,  as  it  also  did  in  the  army,  while  the  average  for  the 
negro  prisoners  falls  in  the  "  D  "  or  inferior  group,  while  the  army  average 
was  "C—  "  or  low  average  group. 

( ■'i-'j  1 


TABLE  o.— DISTRIBUTION  OF  INTELLIGENCE  RATINGS  IN  THE 

WORKHOUSE 


Per  cent 
30 

2.5 

20 

1.5 

10 


Native 
born 
white 

Foreign 
born 

All 
whites 

Negroes 

Race 
unknown 

Total 

Per 

Per 

Per 

Per 

No. 

cent. 

No. 

No. 

cent. 

No. 

cent. 

No. 

No. 

cent. 

A 

B 

o 

4.5 

1 

3 

5.3 

3 

3.2 

c+ 

16 

36.4 

16 

28.0 

16 

17.2 

c 

13 

29.6 

1 

14 

24.5 

2 

6.2 

16 

17.2 

c- 

6 

13.6 

3 

9 

15.8 

/ 

21.9 

16 

17.2 

D 

o 

4.5 

4 

6 

10.5 

9 

28.1 

15 

16.2 

E 

5 

11.4 

4 

9 

15.8 

14 

43.8 

4 

27 

29.0 

Total 

44 

100.0 

13 

57 

99.9 

32 

100.0 

4 

93 

100.0 

i\ 

/ 

\ 

<^^ 

\ 

/ 

\ 

^^^ 

Workhouse     '^ 

Sw. 

^  *  — 

VV 

/ 

/■ 

^ 

/ 

\ 

^^ 

V 

A 

^ 

\ 

\ 

Diagram  4. — Comparison  of  intelligence  distributions  of  Cleveland  Workhouse  and 
United  States  Draft  Army 


43.1 


.Mxi. 


Whites,  VtfftrrenBville  Workhouse 


63.8 


Whites,  United  States  Draft  Army 

JJ^.9 28il 


Negroes,   Warrensville  Workhouse 


sail 


i 


Negroes,  United  States  Draft  Array 

Diagram   5. — Comparison   of  intelligence  ratings,   Warrensville    Workhouse    with 
United  States  Draft  Army 

[56] 


Diagi'am  4  shows  the  distribution  of  inteUigence  ratings  of  the  Cleve- 
land workhouse  with  the  United  States  draft  army.  In  Diagram  5  the 
same  distribution  is  shown  for  whites  and  negroes  separately. 

These  results  would  undoubtedly  be  lowered  if  ratings  of  the  illiterate 
men  were  included,  so  that  it  may  safely  be  said  that  the  intelligence  of 
these  men  at  the  Cleveland  workhouse  is  somewhat  below  the  draft  army 
intelligence. 


57 


APPENDIX   III 

TEXT  OF  THE  MASSACHUSETTS  MEDICAL  EXAMINER 

LAW 

The  Commonwealth  of  Massachusetts 
General  Laws,  Chapter  38 

Medical  Examiners 

Section  1.  The  governor,  wath  the  advice  and  consent  of  the  council, 
shall  appoint  for  terms  of  seven  years  able  and  discreet  men,  learned  in  the 
science  of  medicine,  as  medical  examiners  in  and  for  their  respective  counties, 
and  as  associate  medical  examiners  in  and  for  their  respective  districts  in  coun- 
ties divided  into  districts,  otherwise  in  and  for  their  respective  counties,  in 
number  as  follows: 

Two  examiners  and  two  associate  examiners  in  Suffolk  county,  and  one 
examiner  and  one  associate  examiner  in  Nantucket  county  and  in  each  of  the 
following  districts : 

Barnstable  county,  district  one,  comprising  Harwich,  Dennis,  Yarmouth, 
Brewster,  Chatham,  Orleans  and  Eastham;  district  two,  Barnstable,  Bourne, 
Sandwich,  Mashpee  and  Falmouth;  and  district  three,  Provincetown,  Truro 
and  Wellfleet. 

Berkshire  county,  district  one,  comprising  North  Adams,  Williamstown, 
Clarksburg,  Adams,  Florida,  Savoy,  New  Ashford  and  Cheshire;  district  two, 
Pittsfield,  Lanesborough,  Windsor,  Dalton,  Hinsdale,  Peru  and  Hancock;  dis- 
trict three,  Richmond,  Lenox,  Washington,  Becket,  Lee,  Stockbridge,  TjTing- 
ham  and  Otis;  and  district  four.  West  Stockbridge,  Alford,  Great  Barrington, 
Monterey,  Sandisfield,  New  Marlborough,  Sheffield,  Egremont  and  Mount 
Washington. 

Bristol  county,  district  one,  comprising  Attleboro,  North  Attleborough, 
Seekonk,  Norton,  Mansfield  and  Rehoboth;  district  two,  Taunton,  Raynham, 
Easton,  Berkley,  and  Dighton;  district  three.  Fall  River,  Somerset,  Swansea, 
Freetown  and  Wcstport;  and  district  four,  New  Bedford,  Dartmouth,  Fair- 
haven  and  Acushnet. 

Dukes  county,  district  one,  comprising  Edgartown  and  Oak  Bluffs;  dis- 
trict two,  Tisbury,  West  Tisbury  and  Gosnold;  and  district  three,  Chilmark 
and  Gay  Head. 

Essex  county,  district  one,  comprising  Gloucester  and  Rockport;   district 

[58] 


two,  Ipswich,  Rowley,  Hamilton  and  Essex;  district  three,  Newburj'port,  New- 
bur>',  West  Newburj',  Amesbury  and  Salisburj';  district  four,  Haverhill  and 
Merrimac;  district  five,  Lawrence,  Methuen,  Andover  and  North  Andover; 
district  six,  Georgetown,  Boxford,  Topsfield  and  Groveland;  district  seven, 
Beverly,  Wenham  and  Manchester;  district  eight,  Peabody,  Danvers,  Middle- 
ton  and  Lynnfield;  district  nine,  Lynn,  Saugus,  Nahant  and  Swampscott;  and 
district  ten,  Salem  and  Marblehead. 

Franklin  county,  the  northern  district,  comprising  Orange,  Warwick,  New 
Salem  and  Wendell;  the  eastern  district,  Bernardston,  Erving,  Gill,  Greenfield, 
Leverett,  Montague,  Xorthfield,  Shutesbury  and  Sunderland;  and  the  western 
district,  Ashfield,  Buckland,  Charlemont,  Colrain,  Conway,  Deerfield,  Hawley, 
Heath,  Leyden,  Monroe,  Rowe,  Shelburne  and  Whately. 

Hampden  county,  district  one,  comprising  Brimfield,  Holland,  Palmer, 
Monson  and  Wales;  district  two,  Springfield,  Agawam,  East  I^ngmeadow, 
Ix)ngmeadow,  West  Springfield,  Wilbraham  and  Hampden;  district  three, 
Holyoke;  district  four,  Blandford,  Chester,  Granville,  Montgomery,  Russell, 
Southwick,  Tolland  and  Westfield;  and  district  five,  Chicopee  and  Ludlow. 

Hampshire  countj',  district  one,  comprising  Northampton,  Chesterfield, 
Cummington,  Goshen,  Hatfield,  Plainfield  and  Williamsburg;  district  two, 
Easthampton,  Huntington,  Middlefield,  Southampton,  Westhampton  and 
Worthington;  district  three,  Amherst,  Granby,  Hadley,  Pelham  and  South 
Hadley ;  and  district  four,  Belcherto\\Ti,  Enfield,  Greenwich,  Prescott  and  Ware. 

Middlesex  county,  district  one,  comprising  Cambridge,  Belmont  and  Arling- 
ton; district  two,  Maiden,  Somerville,  Everett  and  Medford;  district  three, 
Melrose,  Stoneham,  Wakefield,  Wilmington,  Reading  and  North  Reading;  dis- 
trict four,  Woburn,  Winchester,  Lexington  and  Burlington;  district  five,  Lowell, 
Dracut,  Tewksburj-,  Billerica,  Chelmsford  and  Tyngsborough ;  district  six, 
Concord,  Carlisle,  Bedford,  Lincoln,  Littleton,  Acton  and  Boxborough;  district 
seven,  Newlon,  Waltham,  Watertowm  and  Weston;  district  eight,  Framingham, 
Waj'land,  Natick,  Sherborn,  HoUiston,  Hopkinton  and  Ashland;  district  nine, 
>Larlborough.  Hudson,  Maynard,  Stow  and  Sudburv^;  district  ten,  Ayer,  Groton, 
Westford,  Dunstable,  Pepperell,  Shirley,  To\\iisend  and  Ashby. 

Norfolk  county,  district  one,  comprising  Dedham,  Needham,  Wellesley, 
Westwood,  Norwood  and  Dover;  district  two,  Cohasset;  district  three,  Quincy, 
Milton  and  Randolph;  district  four,  Wej-mouth,  Braintree  and  Holbrook;  dis- 
trict five,  Avon,  Stoughton,  Canton,  Walpole  and  Sharon;  district  six,  Frank- 
lin, Foxborough  and  Wrentham;  district  seven,  Medway,  Medfield,  Millis, 
Norfolk  and  Bellingham;  and  district  eight,  Brookline. 

Plymouth  county,  district  one,  comprising  Brockton,  West  Bridgewater, 
East  Bridgewater,  Bridgewater  and  Whitman;  district  two,  Abington,  Rock- 
land, Hanover,  Hanson,  Norwell  and  Pembroke;  district  three,  Plymouth, 
Halifax,  Kingston,  Plympton  and  Duxbury;  district  four,  Middlelxirough, 
Wareham,  >Iattapoisett,  Carver,  Rochester,  Lakeville  and  Marion;  and  dis- 
trict five,  Hingham,  Hull,  Scituate  and  Marshfield. 

[59] 


Worcester  county,  district  one,  comprising  Athol,  Dana,  Petersham,  Phillips- 
ton  and  Royalston;  district  two,  Gardner,  Templeton  and  Winchendon;  dis- 
trict three,  Fitchburg,  Ashburnham,  Leominster,  Lunenburg,  Princeton  and 
Westminster;  district  four,  Berlin,  Bolton,  Boylston,  Clinton,  Harvard,  Lan- 
caster and  Sterling;  district  five,  Grafton,  Northborough,  Southborough  and 
Westborough;  district  six,  Hopedale,  Mendon,  IMilford  and  Upton;  district 
seven,  Blackstone,  Douglas,  Millvillc,  Northbridge  and  Uxbridge;  district  eight, 
Charlton,  Dudley,  Oxford,  Southbridge,  Sturbridge  and  Webster;  district  nine, 
Brookfield,  East  Brookfield,  North  Broolvfield,  Spencer,  Warren  and  West 
Brookfield;  district  ten,  Barre,  Hubbardston,  Hardwick,  New  Braintree,  Oak- 
ham and  Rutland;  and  district  eleven,  Worcester,  Auburn,  Holden,  Leicester, 
Millbury,  Paxton,  Shrewsbury,  Sutton  and  West  Boylston. 

Section  2.  The  associate  medical  examiners  for  Suffolk  county  shall,  at 
the  request  of  either  of  its  medical  examiners,  perform  the  duties  and  have 
the  powers  of  medical  examiners.  Each  medical  examiner  shall  in  each  year  be 
entitled  to  two  months'  service  in  the  aggregate  from  the  associates.  Associate 
examiners  in  the  other  counties  shall,  in  the  absence  of  the  medical  examiners 
or  in  case  of  their  inability  to  act,  perform  in  their  respective  districts  all  the 
duties  of  medical  examiners. 

Section  3.  Each  examiner  and  associate  examiner,  before  entering  upon 
his  duties,  shall  be  sworn  and  give  bond  for  the  faithful  performance  thereof, 
in  the  sum  of  five  thousand  dollars,  to  the  county  treasurer,  with  sureties  by 
him  approved.  Failure  for  three  months  after  appointment  to  give  such  bond 
shall  render  his  appointment  void.  A  surety  or  his  executors  or  administrators 
may  be  discharged  from  further  liability  thereon  in  the  manner  provided  in 
section  six  of  chapter  thirty-seven. 

Section  4.  Upon  breach  of  the  condition  of  such  bond  to  the  injury  of 
any  person,  the  principal  may  be  removed  from  office  and  action  brought  thereon 
in  like  manner  as  upon  the  bond  of  a  sheriff. 

Section  5.  In  SufTolk  county  each  medical  examiner  shall  receive  from 
the  county  a  salary  of  five  thousand  dollars,  and  each  associate  medical  examiner 
a  salary  of  eight  hundred  and  thirty-three  dollars;  but  if  either  associate  serves 
in  any  year  more  than  two  months,  he  shall  for  such  additional  service  be  paid 
at  the  same  rate,  and  the  amount  so  paid  shall  be  deducted  from  the  salary  of 
the  medical  examiner  at  whose  request  he  so  serv^es.  The  medical  examiners 
for  said  county  shall  be  provided  with  rooms  suitably  furnished  for  the  per- 
formance of  their  duties,  the  rent,  furnishing  and  office  equipment  of  which 
shall  be  paid  for  by  said  county  upon  approval  of  the  mayor  of  Boston.  Each 
of  said  medical  examiners  may,  in  the  name  of  the  county,  contract  such  bills 
for  clerical  service,  postage,  stationery,  printing,  telephone,  traveling,  and  for 
such  other  incidental  expenses  as  may  in  his  opinion  be  necessary  for  the  proper 
performance  of  his  duty,  to  an  amount  not  exceeding  six  thousand  dollars  in 
any  one  year;  and  each  associate  may  so  contract  bills  for  the  said  purposes 

[60] 


to  an  amount  not  exceeding  one  thousand  dollars  in  anj'  one  year;  and  all  such 
bills  shall  be  paid  by  said  county,  upon  a  certificate  by  the  contracting  examiner 
that  they  were  necessarily  incurred  in  the  performance  of  his  duty,  and  upon 
the  approval  of  the  auditor  of  Boston,  as  provided  in  section  nineteen,  and  of 
the  mayor.  Medical  examiners  and  associate  medical  examiners  in  other  coun- 
ties shall  receive  fees  as  follows:  For  a  view  without  an  autopsy,  seven  dollars; 
for  a  view  and  an  autopsy,  thirty  dollars;  and  for  travel,  ten  cents  a  mile  to 
and  from  the  place  of  view. 

Section  6.  Medical  examiners  shall  make  examination  upon  the  view  of 
the  dead  bodies  of  only  such  persons  as  are  supposed  to  have  died  by  violence. 
If  a  medical  examiner  has  notice  that  there  is  within  his  county  the  body  of 
such  a  person,  he  shall  forthwith  go  to  the  place  where  the  body  lies  and  take 
charge  of  the  same;  and  if,  on  view  thereof  and  personal  inquiry  into  the  cause 
and  manner  of  death,  he  considers  a  further  examination  necessary,  he  shall, 
upon  WTitten  authorization  of  the  district  attorney,  mayor  or  selectmen  of  the 
district,  city  or  town  where  the  body  lies,  make  an  autopsy  in  the  presence  of 
two  or  more  discreet  persons,  whose  attendance  he  may  compel  by  subpcena. 
Before  making  such  autopsy  he  shall  call  the  attention  of  the  witnesses  to  the 
appearance  and  position  of  the  body.  He  shall  then  and  there  carefully  record 
every  fact  and  circumstance  tending  to  show  the  condition  of  the  body  and  the 
cause  and  manner  of  death,  with  the  names  and  addresses  of  said  witnesses,  which 
record  he  shall  subscribe.  If  a  medical  examiner  or  an  associate  examiner  con- 
siders it  necessary  to  have  a  physician  present  as  a  witness  at  an  autopsy,  such 
physician  shall  receive  a  fee  of  five  dollars.  Other  witnesses,  except  officers 
named  in  section  fifty  of  chapter  two  hundred  and  sixty-two,  shall  be  allowed 
two  dollars  each.  A  clerk  may  be  employed  to  reduce  to  writing  the  results  of 
a  medical  examination  or  autopsy,  and  shall  receive  two  dollars  a  day. 

The  medical  examiner  may,  if  he  considers  it  necessary,  employ  a  chemist 
to  aid  in  the  examination  of  the  body  or  of  substances  supposed  to  have  caused 
or  contributed  to  the  death,  and  he  shall  receive  such  compensation  as  the 
examiner  certifies  to  be  just  and  reasonable. 

Section  7.  He  shall  forthwith  file  with  the  district  attorney  for  his  dis- 
trict a  report  of  each  autopsy  and  view  and  of  his  personal  inquiries,  with  a 
certificate  that,  in  his  judgment,  the  manner  and  cause  of  death  could  not  be 
ascertained  by  view  and  inquiry  and  that  an  autopsy  was  necessary.  The  dis- 
trict attorney,  if  he  concurs,  shall  so  certify  to  the  commissioners  of  the  county 
where  the  same  was  held,  or  in  Suffolk  county,  to  the  auditor  of  Boston.  If 
upon  such  view,  personal  incjuiry  or  autopsy,  the  medical  examiner  is  of  opinion 
that  the  death  may  have  been  caused  by  the  act  or  negligence  of  another,  he 
shall  at  once  notify  the  district  attorney  and  a  justice  of  a  district  court  or  trial 
justice  within  whose  jurisdiction  the  body  was  found,  if  the  place  where  found 
and  the  place  of  the  said  act  or  negligence  are  within  the  same  county,  or  if 
the  latter  place  is  unknown;  otherwise,  the  district  attorney  and  such  a  justice 

161) 


within  whose  district  or  jurisdiction  the  said  act  or  negligence  occurred.  He 
shall  also  file  with  the  district  attorney  thus  notified,  and  with  the  justice  or  in 
his  court,  an  attested  copy  of  the  record  of  the  autopsy  made  as  provided  in  the 
preceding  section.  He  shall  in  all  cases  certify  to  the  town  clerk  or  registrar  in 
the  place  where  the  deceased  died  his  name  and  residence,  if  known;  otherwise 
a  description  as  full  as  may  be,  with  the  cause  and  manner  of  death. 

Section  8.  The  court  or  trial  justice  shall  thereupon  hold  an  inquest, 
from  which  all  persons  not  required  by  law  to  attend  may  be  excluded.  The 
district  attorney,  or  any  person  designated  by  him,  may  attend  the  inquest 
and  examine  the  witnesses,  who  may  be  kept  separate,  so  that  they  cannot 
converse  with  each  other  until  they  have  been  examined.  Within  sixty  days 
after  any  case  of  death  by  accident  upon  a  railroad,  electric  railroad,  street 
railway  or  railroad  for  private  use  an  inquest  shall  be  held,  and  the  court  or 
justice  shall  give  seasonable  notice  of  the  time  and  place  thereof  to  the  depart- 
ment of  public  utilities.  Within  a  like  period  after  any  case  of  death  in  which 
a  motor  vehicle  is  involved,  an  inquest  shall  be  held,  and  the  court  or  justice 
shall  give  seasonable  notice  of  the  time  and  place  thereof  to  the  department  of 
public  works.  The  attorney  general  or  the  district  attorney  may,  notwith- 
standing the  medical  examiner's  report  that  a  death  was  not  caused  by  the  act 
or  negligence  of  another,  direct  an  inquest  to  be  held,  and  Ukewise  in  case  of 
death  by  any  casualty. 

Section  9.  If  it  appears  that  the  place  where  the  supposed  act  or  negli- 
gence occurred  and  the  place  where  the  body  was  found  are  both  without  the 
limits  of  the  judicial  district  of  the  court  or  the  jurisdiction  of  the  trial  justice 
notified  by  the  medical  examiner  under  section  seven,  the  court  or  justice  shall 
nevertheless  proceed  with  the  inquest  and  have  continuous  and  exclusive  juris- 
diction thereof  if  either  place  is  within  the  commonwealth  and  within  fifty  rods 
of  the  boundary  line  of  such  district  or  jurisdiction,  unless  a  prior  and  like 
notice  shall  have  been  issued  by  a  medical  examiner  in  another  county  in  ac- 
cordance with  said  section. 

Section  10.  A  district  court  about  to  hold  an  inquest  may  appoint  an 
officer  qualified  to  serve  criminal  process  to  investigate  the  case  and  to  sum- 
mon the  witnesses,  and  may  allow  him  additional  compensation  therefor,  pay- 
able in  like  manner  as  the  fees  of  officers  in  criminal  cases. 

Section  11.  If  a  magistrate  believes  that  an  inquest  to  be  held  by  him 
relates  to  the  accidental  death  of  a  passenger  or  employee  upon  a  railroad  or 
electric  railroad  or  a  traveler  upon  a  public  or  private  way  at  a  railroad  cross- 
ing, or  to  an  accidental  death  connected  with  the  operation  of  a  street  railway 
or  of  a  railroad  for  private  use,  he  shall  cause  a  verbatim  report  of  the  evidence 
to  be  made  and  sworn  to  by  the  person  making  it;  and  the  report  and  the  bill 
for  services,  after  examination  and  written  approval  l).y  the  magistrate,  shall  be 
forwarded  to  the  department  of  public  utiliti(>s  witliin  thirty  days  after  the 
date  of  the  inquest,  and,  when  made,  a  copy  of  the  magistrate's  report  on  the 

[62] 


inquest.  The  bill,  when  approved  by  said  department,  siiall  !>(>  forwarded  to 
the  state  auditor  and  paid  by  the  commonwealth,  assessed  on  the  person  own- 
ing or  operating  such  railroad  or  railway,  and  shall  be  collected  in  the  same 
manner  as  taxes  upon  corporations.  The  magistrate  may  in  his  discretion  refuse 
fees  to  witnesses  in  the  employ  of  the  person  upon  whose  railroad  or  railway  the 
accident  occurred. 

Section  12.  The  magistrate  shall  report  in  writing  when,  where  and  by 
what  means  the  person  met  his  death,  his  name,  if  known,  and  all  material 
circumstances  attending  his  death,  and  the  name,  if  known,  of  any  person  whose 
unlawful  act  or  negligence  appears  to  have  contributed  thereto.  He  shall  file 
his  report  in  the  superior  court  for  the  county  where  the  inquest  is  held. 

Section  13.  If  a  person  charged  bj''  the  report  with  the  commission  of  a 
crime  is  at  large,  the  magistrate  shall  forthwith  issue  process  for  his  arrest, 
returnable  before  any  court  or  magistrate  having  jurisdiction.  If  he  finds  that 
murder,  manslaughter  or  an  assault  has  been  committed,  he  may  bind  over, 
for  appearance  in  said  court,  as  in  criminal  cases,  such  witnesses  as  he  considers 
necessary,  or  as  the  district  attorney  may  designate. 

Section  14.  No  embalming  fluid,  or  any  substitute  therefor,  shall  be  in- 
jected into  the  body  of  any  person  supposed  to  have  met  his  death  by  violence, 
until  a  permit,  signed  by  the  medical  examiner,  has  first  been  obtained. 

Section  15.  After  an  autopsy  or  a  view  or  examination  without  an  autopsy, 
the  medical  examiner  shall  deliver  the  body,  upon  application,  to  the  husband 
or  wife,  to  the  next  of  kin,  or  to  any  friend  of  the  deceased,  who  shall  have 
priority  in  the  order  named.  If  the  body  is  unidentified  or  unclaimed  for  forty- 
eight  hours  after  the  view  thereof,  the  medical  examiner  shall  deliver  it  to  the 
overseers  of  the  poor  of  the  town  where  found,  who  shall  bury  it  in  accordance 
with  section  seventeen  of  chapter  one  hundred  and  seventeen. 

Section  16.  Medical  examiners  and  associate  examiners  within  their  re- 
spective districts  shall,  on  application  and  payment  or  tender  of  seven  dollars, 
view  the  body  and  make  personal  inquirj^  concerning  the  death  of  any  person 
whose  body  is  intended  for  cremation,  and  shall  authorize  such  cremation  only 
when  of  opinion  that  no  further  examination  or  judicial  inquiry  concerning  such 
death  is  necessary. 

Section  17.  The  medical  examiner  may  allow  reasonable  compensation, 
payable  by  the  county  in  the  manner  provided  in  section  nineteen,  for  services 
rendered  in  bringing  to  land  a  human  body  found  in  any  of  the  harbors,  rivers 
or  waters  of  the  commonwealth,  but  this  provision  shall  not  entitle  any  person 
to  compensation  for  services  rendered  in  searching  for  a  dead  body. 

Section  18.  The  medical  examiner  shall  take  charge  of  any  money  or 
other  per.s6nal  property  of  the  decea.sed  found  on  or  near  the  body,  and  deliver 
it  to  the  person  entitled  to  its  custody  or  possession,  or,  if  not  claiincd  within 

[63] 


sixty  days,  to  a  public  administrator.  For  fraudulent  neglect  or  refusal  so  to 
deliver  such  property  within  three  days  after  demand,  a  medical  examiner  or 
an  associate  medical  examiner  shall  be  punished  by  a  fine  of  not  more  than  five 
hundred  dollars  or  by  imprisonment  for  not  more  than  two  years. 

Section  19.  Every  medical  examiner  shall  return  an  account  of  the  ex- 
penses of  each  view  or  autopsy,  including  his  fees,  to  the  commissioners  of  the 
county  where  held,  or  in  Suffolk  county  to  the  auditor  of  Boston,  and  shall 
annex  to  his  return  the  written  authorization  of  the  autopsy.  The  commis- 
sioners or  auditor  shall  audit  the  same,  and  certify  to  the  county  treasurer  what 
items  therein  are  just  and  reasonable,  and  he  shall  pay  the  same  to  the  person 
entitled  thereto.  No  auditing  officer  shall  certify  any  fee  for  an  autopsy  until 
he  has  received  from  the  district  attorney  the  certificate  required  by  section 
seven. 

Section  20.  Every  medical  examiner  and  associate  examiner  shall  an- 
nually, on  or  before  March  first,  transmit  to  the  state  secretary  certified  copies 
of  the  records  of  all  deaths  by  him  investigated  during  the  preceding  year,  and 
within  sixty  days  after  the  expiration  of  his  term  shall  make  like  returns  for  so 
much  of  the  j^ear  as  he  held  office.  For  a  refusal  or  neglect  so  to  do,  he  shall 
forfeit  not  less  than  ten  nor  more  than  fifty  dollars. 

Section  21.  Each  medical  examiner  and  associate  examiner,  including 
those  in  Suffolk  county,  shall  receive  from  the  commonwealth  twenty  cents  for 
each  of  the  first  twentj^  deaths  recorded  and  returned  by  him  in  any  year,  as 
provided  in  the  preceding  section,  and  ten  cents  for  each  additional  death  so 
recorded  and  returned,  as  certified  by  the  state  secretary. 

Section  22.  The  state  secretary  shall,  at  the  expense  of  the  common- 
wealth, prepare  and  furnish  to  the  medical  examiners  blank  record  books  and 
blank  forms  for  returns,  and  shall  cause  the  returns  for  each  year  to  be  bound 
together  in  one  volume  with  indexes;  and  shall  prepare  therefrom  such  tables 
as  will  render  them  of  utility,  and  shall  make  annual  report  thereof  to  the  gen- 
eral court  in  connection  with  the  report  required  by  section  twenty-one  of 
chapter  forty-six. 


64 


APPENDIX   IV 

TEXT  OF  THE  NEW  YORK  MEDICAL  EXAMINER  LAW 

Laws  of  New  York,  1915 
Chap.  £84 
AX  ACT  to  amend  the  Greater  New  York  Charter,  and  repeal   certain 
ZA     sections  thereof  and  of  chapter  four  hundred  and  ten  of  the  Laws  of 
A,    ^  eighteen  hundred  and  eightj^-two,  in  relation  to  the  abolition  of  the 
office  of  Coroner  and  the  establishment  of  the  office  of  the  chief  medical  examiner. 
Became  a  law  April  14,  1915,  with  the  approval  of  the  Governor.    Passes, 
three-fifths  being  present. 

Accepted  by  the  City 

The  People  of  the  State  of  New  York,  represented  in  Senate  and  Assembly, 
do  enact  as  follows: 

Section  1.  The  office  of  coroner  in  the  City  of  New  York  shall  be  abolished 
on  January  first,  nineteen  hundred  and  eighteen,  and  after  this  section  takes 
effect,  a  vacancy  occurring  in  such  an  office  in  any  borough  shall  not  be  filled 
unless  by  reason  of  the  occurrence  thereof,  there  shall  be  no  coroner  in  office 
in  such  borough,  in  which  case  the  vacancy  in  such  borough  last  occurring  shall 
be  filled  for  a  term  to  expire  on  January  first,  nineteen  hundred  and  eighteen. 
If,  by  reason  of  the  provisions  of  this  section,  the  number  of  coroners  in  a  borough 
be  reduced,  the  remaining  coroner  or  coroners  in  such  borough  shall  have  the 
powers  and  perform  the  duties  conferred  or  imposed  by  law  on  the  board  of 
coroners  in  such  borough. 

2.  Title  four  of  chapter  twentj^-three,  sections  fifteen  hundred  and  seventy 
and  fifteen  hundred  and  seventy-one  of  the  Greater  New  York  charter,  as  re- 
enacted  by  chapter  four  hundred  and  sixty-six  of  the  laws  of  nineteen  hundred 
and  one  is  hereby  repealed,  and  in  its  place  is  inserted  a  new  title  to  be  num- 
bered four  and  to  read  as  follows : 

Title  IV 
Chief  Medical  Examiner 
Section  1570.      Organization  of  office;  officers  and  employees. 
1571.      Violent  and  suspicious  deaths;  procedure. 
1571a.    Autopsies;  findings. 
1571b.    Report  of  deaths;  removal  of  body. 
-  1571c.    Records. 
1571d.    Oaths  and  affidavits. 
6  [65] 


Organization  of  Office;  Officers  and  Employees 

1570.  There  is  hereby  established  the  office  of  Chief  Medical  Examiner  of 
the  City  of  New  York.  The  head  of  the  office  shall  be  called  the  "chief  medical 
examiner."  He  shall  be  appointed  by  the  mayor  from  the  classified  service  and 
be  a  doctor  of  medicine,  and  a  skilled  pathologist  and  microscopist. 

The  mayor  may  remove  such  officer  upon  stating  in  \vriting  his  reasons 
therefor,  to  be  filed  in  the  office  of  the  municipal  civil  service  commission  and 
served  upon  such  officer,  and  allowing  him  an  opportunity  of  making  a  public 
explanation.  The  chief  medical  examiner  may  appoint  and  remove  such  deputies, 
assistant  medical  examiners,  scientific  experts,  officers  and  employees  as  may 
be  provided  for  pursuant  to  law.  Such  deputy  medical  examiners  and  assistant 
medical  examiners,  as  may  be  appointed,  shall  possess  qualifications  similar  to 
those  required  in  the  appointment  of  the  chief  medical  examiner.  The  office 
shall  be  kept  open  every  day  in  the  year,  including  Sundays  and  holidays,  with 
a  clerk  in  constant  attendance  at  all  times  during  the  day  and  night. 

Violent  and  Suspicious  Deaths;  Procedure 

1571.  When,  in  the  city  of  New  York,  any  person  shall  die  from  criminal 
violence,  or  bj'  a  casualty,  or  by  suicide,  or  suddenly  when  in  apparent  health, 
or  when  unattended  by  a  physician,  or  in  prison,  or  in  anj^  suspicious  or  unusual 
manner,  the  officer  in  charge  of  the  station  house  in  the  police  precinct  in  which 
such  person  died  shall  immediately  notify  the  office  of  the  chief  medical  examiner 
of  the  known  facts,  concerning  the  time,  place,  manner  and  circumstances  of 
such  death.  Immediately  upon  receipt  of  such  notification  the  chief  medical 
examiner,  or  a  deputy  or  assistant  medical  examiner,  shall  go  to  the  dead  body, 
and  take  charge  of  the  same.  Such  examiner  shall  fully  investigate  the  essential 
facts  concerning  the  circumstances  of  the  death,  taking  the  names  and  address 
of  as  many  witnesses  thereto  as  it  may  be  practical  to  obtain,  and  before  leaving 
the  premises,  shall  reduce  all  such  facts  to  writing  and  file  the  same  in  his  office. 
The  police  officer  so  detailed,  shall,  in  the  absence  of  the  next  of  kin  of  deceased 
person,  take  possession  of  all  property  of  value  found  on  such  person,  make  an 
exact  inventory  thereof  on  his  report,  and  deliver  such  property  to  the  police 
department,  which  shall  surrender  the  same  to  the  person  entitled  to  its  custody 
or  possession.  Such  examiner  shall  take  possession  of  any  portable  objects, 
which,  in  his  opinion,  maj'^  be  useful  in  establishing  the  cause  of  death,  and 
deliver  them  to  the  police  department. 

Nothing  in  this  section  contained  shall  effect  the  powers  and  duties  of  a 
public  administrator  as  now  provided  bj^  law. 

A  utopsies;  Fi  ndings 
1571a.     If  the  cause  of  such  death  shall  be  established  beyond  a  reasonable 
doubt,  the  medical  examiner  in  charge  shall  so  report  to  his  office.    If,  however, 
in  the  opinion  of  such  medical  examiner,  an  autopsy  is  necessary,  the  same  shall 

[66] 


be  performed  by  a  medical  examiner.  A  detailed  description  of  tlie  findings 
WTitten  during  the  progress  of  such  autopsy  and  the  conclusions  drawn  there- 
from shall  thereupon  be  filed  in  his  office. 


Report  of  Deaths;  Removal  of  Body 
1571b.  It  shall  be  the  duty  of  any  citizen  who  may  become  aware  of  the 
death  of  any  such  person  to  report  such  death  forthwith  to  the  office  of  the 
chief  medical  examiner  and  the  police  officer,  who  shall  forthwith  notify  the 
officer  in  charge  of  the  station  house  in  the  police  precinct  in  which  such  person 
died.  Any  person  who  shall  wilfully  neglect  or  refuse  to  report  such  death  or 
who,  without  ^\Titten  order  from  a  medical  examiner,  shall  wilfully  touch,  re- 
move or  disturb  the  body  of  any  such  person,  or  wilfully  touch,  remove  or  dis- 
turb the  clothing,  or  an)'  article  upon  or  near  such  bodj',  shall  be  guilty  of  a 
misdemeanor. 

Records 
1571c.  It  shall  be  the  duty  of  the  office  of  medical  examiner  to  keep  full 
and  complete  records.  Such  records  shall  be  kept  in  the  office,  properly  indexed, 
stating  the  name,  if  kno^sTi,  of  every  such  person,  the  place  where  the  body  was 
found,  the  date  of  death.  The  record  of  each  case  shall  be  attached  to  the  original 
report  of  the  medical  examiner  and  the  detailed  findings  of  the  autopsy,  if  any. 
The  office  shall  promptly  deliver  to  the  appropriate  district  attorney  copies  of 
all  records  relating  to  every  death  as  to  which  there  is,  in  the  judgment  of  the 
medical  examiner  in  charge,  any  indication  of  criminality.  All  other  records 
shall  be  open  to  public  inspection  as  provided  in  section  fifteen  hundred  and 
forty-five.  The  appropriate  district  attorney  and  the  police  commissioner  of 
the  cit}'  may  require,  from  such  officer,  such  further  records  and  such  daily 
information  as  they  may  deem  necessar>'. 

Oaths  and  Affidavits 

1571d.  The  chief  medical  examiner  and  all  deputy  or  assistant  medical 
examiners  may  administer  oaths  and  take  affidavits,  proofs  and  examinations 
as  to  anj'  matter  within  the  jurisdiction  of  the  office. 

3.  Section  eleven  hundred  and  seventy-nine  of  such  charter  is  hereby 
amended  to  read  as  follows: 

Bureaus 
1 179.  There  shall  be  two  bureaus  in  the  department  of  health.  The  chief 
officer  of  one  bureau  shall  be  called  the  sanitary  superintendent,  who  at  the 
time  of  his  appointment  shall  have  been,  for  at  least  ten  years,  a  practicing 
physician,  and  for  three  years  a  resident  of  the  City  of  New  York,  and  he  shall 
be  the  chief  executive  officer  of  said  department.  The  chief  officer  of  the  second 
bureau  shall  be  called  the  registrar  of  records,  and  in  said  bureau  shall  be  re- 

[C7  1 


corded,  without  fees,  every  birth,  marriage  and  death,  which  shall  occur  in  the 
City  of  New  York. 

4.  Section  twelve  hundred  and  three  of  such  charter  is  hereby  amended 
to  read  as  follows: 

Chief  Medical  Examiner's  Returns 
1203.  The  department  of  health,  may,  from  time  to  time,  make  rules  and 
regulations  fixing  the  time  of  rendering,  and  defining  the  form  of  returns  and 
reports  to  be  made  to  said  department  by  the  office  of  the  chief  medical  examiner 
of  the  city  of  New  York,  in  all  cases  of  death  which  shall  be  investigated  by  it, 
and  the  office  of  the  chief  medical  examiner  is  hereby  required  to  conform  to 
such  rules  and  regulations. 

5.  Section  twelve  hundred  and  thirty-eight  of  such  charter  is  hereby 
amended  to  read  as  follows: 

Deaths  to  be  Reported 
1238.  It  shall  be  the  duty  of  the  next  of  kin  of  any  person  deceased,  and 
of  each  person  being  with  such  deceased  person  at  his  or  her  death,  to  file  report 
in  writing,  with  the  department  of  health,  within  five  days  after  such  death, 
stating  the  age,  color,  nativity,  last  occupation  and  cause  of  death  of  such 
deceased  person,  and  the  borough  and  street  the  place  of  such  person's  death 
and  last  residence.  Physicians  who  have  attended  deceased  persons  in  their 
last  illness  shall,  in  the  certificate  of  the  deceased  of  such  persons,  specify,  as 
near  as  the  same  can  be  ascertained,  the  name  and  surname,  age,  occupation, 
term  of  residence  in  said  city,  place  of  nativity,  condition  of  life  whether  single 
or  married,  widow  or  widower,  colored,  last  place  of  residence  and  the  cause  of 
death  of  such  deceased  persons,  and  the  medical  examiners  of  the  city  shall,  in 
their  certificates,  conform  to  the  requirements  of  this  section. 

6.  Such  charter  is  hereby  amended  by  inserting  therein  a  new  section  to 
be  numbered  fifteen  hundred  and  eighty-five,  and  to  read  as  follows: 

County  Clerks  to  Exercise  Certain  Statutory  Powers  and  Duties  of  Coroners 
1585a.  In  the  city  of  New  York  the  powers  imposed  and  the  duties  con- 
ferred upon  coroners  by  the  provisions  of  the  title  three  of  chapter  two  of  the 
code  of  civil  procedure  shall  be  exercised  and  performed  by  the  county  clerk  of 
the  appropriate  county,  and  said  county  clerk  shall,  in  the  exercise  and  per- 
formance thereof,  be  subject  to  the  same  liabilities  and  responsibilities  as  are 
prescribed  in  such  title  in  the  case  of  coroners. 

7.  Sections  seventeen  hundred  and  sixty-six  to  seventeen  hundred  and 
seventy-nine,  both  inclusive,  of  chapter  four  hundred  and  ten  of  the  laws  of 
eighteen  hundred  and  eighty-two,  entitled  "An  Act  to  consolidate  into  one  act 
and  to  declare  the  special  and  local  laws  affecting  public  interests  in  the  city 
of  New  York,"  and  all  acts  amending  such  sections  are  hereby  repealed. 

[68] 


8.  The  officers  and  the  employees  now  exercising  the  powers  and  duties 
which  by  this  act  are  aboHshed,  or  are  conferred  or  impxised  upon  the  office  of 
chief  medical  examiner  including  coroner's  physicians,  shall  be  transferred  to 
the  office  of  chief  medical  examiner.  Service  in  the  office,  board  or  body  from 
which  transferred  shall  count  for  all  purposes  as  service  in  the  office  of  the  chief 
medical  examiner. 

9.  All  funds,  property,  records,  books,  papers  and  documents  within  the 
jurisdiction  or  control  of  any  such  coroner  or  such  board  of  coroners,  shall,  on 
demand,  be  transferred  and  delivered  to  the  office  of  the  chief  medical  examiner. 
The  board  of  estimate  and  apportionment  shall  transfer  to  the  office  of  the  chief 
medical  examiner  all  unexpended  appropriations  made  by  the  city  to  enable 
any  coroner,  or  board  of  coroners,  to  exercise  any  of  the  powers  and  duties 
which  by  this  act  are  abolished  or  are  conferred  or  imposed  upon  such  office  of 
chief  medical  examiner. 

10.  Section  one  of  this  act  shall  take  eflect  immediately.  The  remainder 
of  the  act  shall  take  effect  January  first,  nineteen  hundred  and  eighteen. 


69 


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